Topical thrombin-related corneal calcification.
OBJECTIVE
To report a highly unusual case of corneal calcification after brief intraoperative use of topical thrombin.


METHODS
A 44-year-old man underwent sclerouvectomy for ciliochoroidal leiomyoma, during which 35 UNIH/mL lyophilized bovine thrombin mixed with 9 mL of diluent containing 1500 mmol/mL calcium chloride was used. From the first postoperative day, corneal and anterior lenticular capsule calcifications developed, and corneal involvement slightly enlarged thereafter.


RESULTS
A year later, 2 corneal punch biopsies confirmed calcification mainly in the Bowman layer. Topical treatment with 1.5% ethylenediaminetetraacetic acid significantly restored corneal clarity. Six months later, a standard extracapsular cataract extraction with intraocular lens placement improved visual acuity to 20/60.


CONCLUSIONS
This case suggests that topical thrombin drops with elevated calcium concentrations may cause acute corneal calcification in Bowman layer and on the anterior lens capsule.
Kiratli
Hayyam
H
Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Hacettepe Hastanesi, Ankara, Turkey. hkiratli@hacettepe.edu.tr
Irkeç
Murat
M
Alaçal
Sibel
S
Söylemezoğlu
Figen
F
D000328:Adult; D002114:Calcinosis / Q000139:chemically induced*; D002387:Cataract Extraction; D003316:Corneal Diseases / Q000139:chemically induced*; D005130:Eye Hemorrhage / Q000517:prevention & control; D006490:Hemostatics / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007889:Leiomyoma / Q000601:surgery; D007903:Lens Capsule, Crystalline / Q000187:drug effects; D007905:Lens Diseases / Q000139:chemically induced; D019654:Lens Implantation, Intraocular; D008297:Male; D013917:Thrombin / Q000009:adverse effects* / Q000627:therapeutic use; D014604:Uveal Neoplasms / Q000601:surgery
D006490:Hemostatics; D013917:Thrombin