Corneal calcification of acellular porcine corneal stroma following lamellar keratoplasty.
acellular porcine corneal stroma
calcification
lamellar keratoplasty
risk factors
Journal
Acta ophthalmologica
ISSN: 1755-3768
Titre abrégé: Acta Ophthalmol
Pays: England
ID NLM: 101468102
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
revised:
20
09
2020
received:
27
07
2020
accepted:
12
10
2020
pubmed:
2
12
2020
medline:
22
2
2022
entrez:
1
12
2020
Statut:
ppublish
Résumé
To describe the corneal calcification of acellular porcine corneal stroma (APCS) following lamellar keratoplasty (LKP) and identify risk factors. Two cases of APCS calcification were evaluated by slit-lamp photography and anterior segment optical coherence tomography (AS-OCT). von Kossa staining and scanning electron microscope/energy-dispersive spectrometry (SEM/EDS) were performed on pathologic tissue. Associated graft and postoperative risk factors were analysed. Acellular porcine corneal stroma (APCS) cleanliness and element content after rinsing with sterilized water were observed by SEM/EDS and inductively coupled plasma mass spectrometry. Calcium metabolism-related proteins were analysed by protein mass spectrometry. Corneal epithelial defects and postoperative medications were reviewed. Two cases of APCS calcification occurred at 23 and 22 days postoperatively. Anterior segment optical coherence tomography (AS-OCT) and von Kossa staining demonstrated calcium deposition in the superficial stroma composed of calcium, phosphorus and oxygen conforming to the Ca/P ratio of hydroxyapatite. Phosphate crystals were present on the APCS surface and decreased with number of rinsing times. The phosphorus content of APCS was minimal after rinsing 10 times and avoiding excessive corneal swelling. Calcium metabolism-related proteins were downregulated in APCS. Patients with corneal calcification had 1-week postoperative corneal epithelial defects and were treated with three types of phosphorous eyedrops. Acellular porcine corneal stroma (APCS) calcification occurs in the superficial corneal stroma about 1 month after LKP. The application of AS-OCT, von Kossa staining and SEM/EDS provides a basis for the clinical and pathological diagnosis of corneal calcification. The associated risk factors were mainly high phosphorus content and downregulated calcium metabolism-related proteins in APCS. Postoperative epithelial defects, inflammation and use of phosphorous eyedrops may promote corneal calcification.
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
164-174Subventions
Organisme : The Academic Promotion Program and Innovation Project of Shandong First Medical University
ID : 2019RC008
Organisme : The Academic Promotion Program and Innovation Project of Shandong First Medical University
ID : 2019ZL001
Organisme : Taishan Scholar Program
ID : 20150215
Organisme : Taishan Scholar Program
ID : 20161059
Informations de copyright
© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
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