title: Acute calcific band keratopathy: case report and literature review.
abstract: An 86-year-old patient developed a significant intraocular inflammatory reaction after having phacoemulsification. Topical therapy did not eliminate the inflammation, and tissue plasminogen activator (tPA) was injected into the anterior chamber. A white corneal plaque appeared in the previously clear cornea within days of the injection. The lesion was diagnosed as calcific band keratopathy and successfully treated with ethylenediaminetetraacetic acid chelation. Electron microscopy and elemental analysis of a corneal scraping from the lesion established its composition to be mainly calcium and phosphate, validating the diagnosis. This is the seventh reported case of rapid formation of calcific band keratopathy after tPA injection. The pathogenesis of this rare complication involves multiple factors, including alkalinization of the intraocular pH, increased phosphate concentration, and endothelial dysfunction.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors: Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel. elad_moi@netvision.net.il
authors: Elad
authors: E
authors: Moisseiev
authors: Assaf
authors: A
authors: Gal
authors: Lia
authors: L
authors: Addadi
authors: Dan
authors: D
authors: Caspi
authors: Gabi
authors: G
authors: Shemesh
authors: Adi
authors: A
authors: Michaeli
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D002114:Calcinosis / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D002118:Calcium / Q000032:analysis; D015913:Chelation Therapy; D003318:Corneal Opacity / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D004492:Edetic Acid / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000209:etiology; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D008855:Microscopy, Electron, Scanning; D018918:Phacoemulsification / Q000009:adverse effects; D010710:Phosphates / Q000032:analysis; D013052:Spectrometry, X-Ray Emission; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005343:Fibrinolytic Agents; D010710:Phosphates; D004492:Edetic Acid; D010959:Tissue Plasminogen Activator; D002118:Calcium