Daly Mary, Tuft Stephen J, Munro Peter M G
Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, England.
Cornea. 2005 Aug;24(6):761-5. doi: 10.1097/01.ico.0000154040.80442.8b.
To describe the clinical and ultrastructural features of 3 cases of acute corneal calcification following accidental chemical injury.
Three men presented over an 18-month period with unilateral eye injuries sustained when applying an industrial fire retardant. This product is predominantly a gypsum aggregate (calcium sulfate dihydrate) plaster combined under pressure with a set-time accelerator (aluminum sulfate). In each case the tear pH was initially alkaline, and the eyes were irrigated with phosphate-buffered saline according to protocol. Within hours a dense corneal opacity had developed that showed only minor resolution over 3 years of follow-up. Two eyes required corneal graft surgery for visual rehabilitation. Light and electron microscopy and energy dispersive analysis of x-rays (EDAX) was performed on excised tissue.
Light and electron microscopy showed dense mineralization of the anterior stroma with discrete crystalline deposits in the deeper stroma. EDAX of the crystals showed high emission peaks for calcium and phosphorus.
The insolubility, elemental composition, and ultrastructural appearance suggest that the opacity was caused by calcium phosphate deposition. The absence of phosphorus from the listed components of the fire retardant suggests that the use of phosphate-buffered irrigation fluid or the subsequent use of phosphate-buffered drops may have contributed to the deposition of this insoluble crystalline deposit.
描述3例意外化学伤后急性角膜钙化的临床和超微结构特征。
在18个月期间，有3名男性因使用工业阻燃剂时发生单眼损伤前来就诊。该产品主要是石膏骨料（二水硫酸钙）石膏，在压力下与凝固时间促进剂（硫酸铝）混合。在每例病例中，最初泪液pH值呈碱性，按照规程用磷酸盐缓冲盐水冲洗眼睛。数小时内出现致密的角膜混浊，在3年的随访中仅略有消退。2只眼睛需要进行角膜移植手术以恢复视力。对切除的组织进行了光镜和电镜检查以及X射线能谱分析（EDAX）。
光镜和电镜检查显示前基质有致密矿化，深层基质中有离散的晶体沉积。晶体的EDAX显示钙和磷有高发射峰。
不溶性、元素组成和超微结构外观表明混浊是由磷酸钙沉积引起的。阻燃剂所列成分中不含磷，提示使用磷酸盐缓冲冲洗液或随后使用磷酸盐缓冲滴眼液可能促成了这种不溶性晶体沉积物的沉积。
