Ethylenediaminetetraacetic Acid Chelation for Band Keratopathy before Ab Interno Glaucoma Surgery

Abstract

An 87-year-old woman with primary open-angle glaucoma presented to our hospital. Although the combined cataract and minimally invasive glaucoma surgeries (MIGS) were an appropriate surgical option, the presence of band keratopathy made it difficult to perform ab interno glaucoma surgery in her right eye (OD); therefore, the corneal opacity was removed using ethylenediaminetetraacetic acid (EDTA) chelation procedure. One month after chelation, microhook ab interno trabeculotomy and cataract surgery were performed successfully. Clear intraoperative visualization of the angle structures is critical for the success of these MIGS procedures. In glaucomatous eyes that require MIGS, EDTA chelation is a good neoadjuvant therapy for coexisting band keratopathy.

Hallermann-Streiff syndrome diagnosed in the seventh decade of life

“…By optical measurement (OA-2000, Tomey), the lens thickness was 5.08 mm and the axial length was 20.24 mm, but these were unmeasurable due to corneal calcification OS. Small-incisional cataract surgery with +30.00-D IOL implantation combined with goniosynechialysis for treating angle closure OD and EDTA chelation therapy 12 for treating corneal opacity OS were performed. Postsurgically, 1.5% levofloxacin (Nipro, Osaka, Japan) and 0.1% betamethasone (Sanbetason, Santen Pharmaceutical, Osaka, Japan) were applied topically four times daily.…”