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Klin Monbl Augenheilkd
DOI: 10.1055/a-2760-3432
Klinische Studie

Dissolve or Evaporate: an Update to Treatment Modalities in Band-like Keratopathy

Article in several languages: English | deutsch

Authors

  • Tonio Felix Schaffert

    Augenklinik, Universitätsklinikum Freiburg, Deutschland

  • Daniel Böhringer

    Augenklinik, Universitätsklinikum Freiburg, Deutschland

  • Thomas Reinhard

    Augenklinik, Universitätsklinikum Freiburg, Deutschland

  • Philip Christian Maier

    Augenklinik, Universitätsklinikum Freiburg, Deutschland
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Abstract

Background Treatment modalities for band keratopathy (BK), which consists of calcium phosphate deposits in Bowmanʼs layer and upper corneal stromal lamellae, are ethylenediamine tetraacetate (EDTA) chelation and phototherapeutic keratectomy (PTK). In this retrospective study, we compared the effectiveness and the recurrence rate for both methods.

Patients/Material and Methods We conducted a retrospective study of patients with idiopathic BK who had been treated with EDTA-chelation or PTK and who had no other relevant corneal disease. Of 81 patients, 34 were treated with EDTA chelation and 47 with PTK. Demographic data, comorbidities, pre- and postoperative visual acuity, preoperative severity of the disease and technical surgical parameters were recorded. The results were compared descriptively. A telephone survey was conducted to investigate the subjective outcome after surgery and the development of recurrences.

Results Regardless of the preoperative severity of BK, treatment intensity and comorbidities, this study confirmed an equal improvement in visual acuity with both EDTA chelation and PTK. The telephone survey showed that the recurrence rate after PTK was significantly lower than after EDTA-chelation (chi-square = 4.74; p = 0.03, n = 25). However, the postoperative symptomatic relief was similar in both groups.

Conclusion EDTA chelation and PTK as treatment of BK provide equivalent improvement in visual acuity and postoperative symptomatic relief. A lower recurrence rate may be expected with PTK. Further prospective studies would be necessary to confirm our results.

Conclusion Box

Already known:

  • EDTA abrasion and PTK are the two most common treatments for band keratopathy, and each has been demonstrated to be effective independently of the other.

  • To date, methods for recurrence have not been directly compared.

  • Due to the different treatment modalities, it was clinically suspected that PTK could be associated with a lower recurrence rate.

Newly described:

  • This study provides a direct retrospective comparison between the two methods and an examination of the recurrence rate.

  • EDTA abrasion and PTK are clinically equally efficient in terms of postoperative visual acuity improvement.

  • PTK may be associated with a lower recurrence rate.

Fazitbox

Bereits bekannt:

  • EDTA-Abrasio und PTK stellen die beiden häufigsten Behandlungsmöglichkeiten der bandförmigen Keratopathie dar, deren Wirksamkeit unabhängig voneinander bestätigt wurde.

  • Bisher wurden die Methoden im Hinblick auf die Rezidivrate noch nicht direkt verglichen.

  • Aufgrund der unterschiedlichen Behandlungsmodalität bestand die klinische Vermutung, dass die PTK mit einer niedrigeren Rezidivrate vergesellschaftet sein könnte.

Neu beschrieben:

  • Diese Studie stellt einen direkten retrospektiven Vergleich zwischen den beiden Methoden sowie eine Untersuchung der Rezidivrate dar.

  • EDTA-Abrasio und PTK sind klinisch gleichwertig effizient im Hinblick auf die postoperative Visusbesserung.

  • Die PTK könnte mit einer geringeren Rezidivrate einhergehen.

Keywords

band-like keratopathy - band-shaped keratopathy - EDTA - excimer laser


Publication History

Received: 31 August 2025

Accepted: 27 November 2025

Article published online:
12 February 2026

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