Excimer laser-assisted phototherapeutic keratectomies combined to EDTA chelation for the treatment of calcific band keratopathy

Introduction: Calcific band keratopathy (CBK) is a relatively common chronic corneal degeneration and various forms of treatment are mentioned in the literature. Cases description: Two patients (89 and 37 yo, respectively) affected by diffuse long-standing CBK in one eye and complaining of ocular pain, foreign body sensation and decreased visual acuity are reported. An ethylenediaminetetraacetic acid (EDTA) application on the ocular surface was performed associated with a customized no-touch transepithelial phototherapeutic corneal remodeling in one patient and a standard phototherapeutic keratectomy (PTK) in the second patient. Corneal transparency progressively improved in both cases since the early follow-up visits and the cornea became clear 2 weeks after surgery. In both cases, a significant reduction of ocular discomfort was reported. Conclusions: Combining EDTA chelation and excimer laser-assisted PTK represents an useful treatment of band keratopathy even in challenging cases and may help regularize corneal surface and improve corneal clarity.

Prevalence of equine herpesvirus 2 (EHV-2) in equine ocular disease

Equine gammaherpesvirus 2 (EHV-2) has been linked to keratitis and keratoconjunctivitis but has also been isolated in horses showing no signs of disease. The aim of the current study was to assess the importance of EHV-2 infection in the aetiopathogenesis of ocular disease, where the applied treatment failed. Seventy-eight horses with nonhealing ocular disease were examined at the Equine Clinic of the University of Veterinary Medicine and Pharmaceutical Sciences, Brno, Czech Republic, between the years 2009 and 2016. In total, 96 conjunctival swabs were taken and, starting from 2014, peripheral blood leukocytes (PBLs) were also examined in 42 patients. Positive EHV-2 results were detected in 53 ocular swab samples (54.64%) and in 22 PBL samples (51.16%). The horses were divided into three groups according to age, up to 3 years, from 3 to 15 years and older than 15 years. Depending on the clinical presentation, horses were also divided into nonulcerative or ulcerative keratitis, keratouveitis, keratoconjunctivitis, and corneal degeneration groups. The group of young horses had a significantly higher ocular swab positivity compared to the middle group (P = 0.01). Increased bilateral ocular occurrence with decreasing age was observed, although it was not significant (P = 0.04). Significant correlation was confirmed between PBL samples and ocular swabs (P = 0.01). This correlation was even higher in cases of bilateral infection. No significant differences were detected when comparing the groups according to the clinical presentation. This study describes the prevalence of EHV-2 in different age group horses with non-healing keratopathies.