Irrigation with phosphate-buffered saline causes corneal calcification during treatment of ocular burns

Schrage, Norbert; Abu, Sabah S.; Hermanns, Leo; Panfil, Claudia; Dutescu, R Michael

doi:10.1016/j.burns.2019.04.022

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…( 11 ) Phosphate is the main identified player in explaining vascular calcification. ( 12 ) Interestingly, there is a description of corneal calcification after irrigation of phosphate‐buffered saline after burns, ( 13 ) the use of artificial tears, ( 14 ) and a study of an ex vivo eye irritation test showing calcification following phosphate eye drop. ( 13 ) Phosphate and the calcium phosphate product have been implicated in the symptomatology of red and dry eyes in patients with CKD.…”

Section: Discussionmentioning

confidence: 99%

“…( 12 ) Interestingly, there is a description of corneal calcification after irrigation of phosphate‐buffered saline after burns, ( 13 ) the use of artificial tears, ( 14 ) and a study of an ex vivo eye irritation test showing calcification following phosphate eye drop. ( 13 ) Phosphate and the calcium phosphate product have been implicated in the symptomatology of red and dry eyes in patients with CKD. ( 15 ) Of note, most of our patients have secondary hyperparathyroidism, a condition associated to loss of calcification inhibitors such as fetuin, inorganic pyrophosphate, and matrix Gla protein, causing vascular calcification.…”

Section: Discussionmentioning

confidence: 99%

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Corneal and Coronary Calcification in Maintenance Hemodialysis: The Face Is No Index to the Heart

Pessoa,

Santo,

de Deus

et al. 2023

JBMR Plus

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Although the eyes are the main site of metastatic calcification in patients with chronic kidney disease (CKD), corneal and conjunctival calcification (CCC) is poorly evaluated in this population. Whether CCC correlates with coronary artery calcification remains unknown since studies so far have relied on methods with low sensitivity. Our objective was to test the relationship between CCC and coronary calcification based on tomography. This was a cross‐sectional study that included patients on maintenance dialysis. Clinical, demographic, and biochemical data (calcium, phosphorus, parathormone, alkaline phosphatase, and 25(OH)‐vitamin D) were recorded. Hyperparathyroidism was defined as parathyroid hormone (PTH) > 300 pg/mL. CCC was evaluated by anterior segment optical coherence tomography (AS‐OCT), and coronary calcium scores (Agatston method) were assessed by computed tomography. We compared no/mild with moderate/severe CCC. Twenty‐nine patients were included (49.6 ± 15.0 years, 62.1% female, on hemodialysis for 5.7 [2.7–9.4] years, 17.2% with diabetes mellitus, 75.9% with hyperparathyroidism). CCC was found in 82.7% of patients, with median scores of 9 (3, 14.5), ranging from 0 to 16. CCC was classified as absent/mild, moderate, and severe in 27.6%, 20.7%, and 51.7%, respectively. Coronary calcification was found in 44.8% of patients, with median scores of 11 (0, 464), varying from 0 and 6456. We found no significant correlation between coronary calcium scores and CCC (r = 0.203, p = 0.282). Hyperphosphatemia was more frequent in patients with moderate/severe CCC than in those with absent/mild CCC. We concluded that CCC was frequent in patients with CKD on dialysis and did not correlate with coronary calcium scores. Hyperphosphatemia appears to contribute to CCC. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Corneal and Coronary Calcification in Maintenance Hemodialysis: The Face Is No Index to the Heart

Pessoa,

Santo,

de Deus

et al. 2023

JBMR Plus

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“…After activation and local inflammation, normal form and function of the stroma is slowly restored. Stromal healing cascade usually restores stromal transparency [9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Sterile Corneal Infiltrates following Cataract Surgery: Case Series

Franch,

Bini,

Francescutti

et al. 2023

Case Rep Ophthalmol

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We report a case series of 26 eyes of 26 patients undergoing planned cataract surgery from December 2021 to March 2022, who were diagnosed as having whitish round infiltrates in the surgical corneal incisions. The infiltrates were detected at the first check after 5–8 days from cataract surgery and were located either within the main corneal incision and/or in the smaller incisions. Corneal infiltrates (CIs) were single or multiple, without epithelial defects, and painless. All infiltrates were initially treated with full topical antibiotic coverage, in order to control eventual and serious postsurgical infection. However, at daily checks, the clinical course of CIs suggested a sterile etiology. For this reason, steroidal topical treatment was maintained for a long time with slow tapering until complete remission of the CIs. All infiltrates resolved completely in around 30–40 days. The surgical instruments and the sterilization process were scrutinized. A white amorphous material was found mainly on non-disposable anterior chamber cannulas and on irrigation/aspiration tips. Disposable cannulas were adopted, and machinery for cleaning and sterilization procedures were reviewed, with specific reference to water softener renewal. Thanks to these precautions, CIs never occurred again. Finally, our hypothesis was an immune corneal reaction to amorphous deposit on cannula tips. This case series describes a previously unknown complication of cataract surgery and our experience might be useful for other surgeons.

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Verätzungen, chemische Traumata der Augenoberfläche

Schrage¹

2021

Entzündliche Augenerkrankungen

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Irrigation with phosphate-buffered saline causes corneal calcification during treatment of ocular burns

Cited by 6 publications

References 21 publications

Corneal and Coronary Calcification in Maintenance Hemodialysis: The Face Is No Index to the Heart

Corneal and Coronary Calcification in Maintenance Hemodialysis: The Face Is No Index to the Heart

Sterile Corneal Infiltrates following Cataract Surgery: Case Series

Verätzungen, chemische Traumata der Augenoberfläche

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