Unusual case of dystrophic calcification mimicking infective keratitis post cataract surgery- Managed with lamellar keratoplasty

• Author Details:   
• Pallavi Joshi
• Sanjana P
• Girish Budhrani

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Introduction: To report a case of dystrophic calcification mimicking infective keratitis managed with lamellar keratoplasty.
Materials and Methods: A 75yr old patient, one month post eventful (DMD) cataract surgery presented to us with diminution of vision RE. She was on post op prednisolone phosphate eye drops lost to follow up.
Results: On examination non healing epithelial defect was noted with dense whitish opacities in the central and paracentral parts of full thickness corneal stroma mimicking infective infiltrate deposits. On anterior segment OCT deposits appeared to be at deep stromal layer with clear demarcation along the descemets membrane hence underwent deep anterior lamellar keratoplasty.
Histopathology showed the presence of dystrophic calcification along the stromal tissue and no growth on culture. Patient was followed up regularly with final visual outcome of 6/18.
Conclusion: Dystrophic calcification of the cornea, involving corneal stroma is most commonly seen in chronic uveitis, prolonged use of medications over years. Our case shows high index of suspicion must be kept in patients with phosphate medication even for short period of time. AS OCT plays an important role in the decision of lamellar keratoplasty over PKP. With due deligence and use of recent advanced equipments treatment with simple lamellar keratoplasty was possible instead of full thickness keratoplasty avoiding long term visual rehabilitation complications.

Keywords: Dystrophic calcification, Topical steroids, Lamellar keratoplasty.