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E. Y. Tu, C. E. Joslin, J. Sugar, M. E. Shoff; Outcomes of Penetrating Keratoplasty in Acanthamoeba Keratitis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):504.
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To evaluate outcomes of surgical intervention during an outbreak of Acanthamoeba Keratitis at the University of Illinois Eye and Ear Infirmary (IEEI).
Patient diagnostic criteria, treatment and final visual outcome data were collected for all patients diagnosed with Acanthamoeba Keratitis at the IEEI. Patients requiring penetrating keratoplasty were evaluated for graft failure, recurrence of disease and visual outcome.
72 eyes of 65 Acanthamoeba Keratitis patients diagnosed from May 2003 through May 2007, completing treatment by October 2007, were included. Analyzing only the first eye of bilateral patients, overall final visual acuity data was available in 61 of 65 (93.8%) eyes; final visual acuity was 20/25 or better in 40 (65.6%) patients; 20/40 or better in 53 (86.9%) with only 4 (6.6%) 20/80 or worse. 13 eyes of 12 patients underwent penetrating keratoplasty. In the 12 eyes (16.7%) with active disease requiring transplantation, 9 (75%) saw 20/40 or better at last follow up. Three recurrences were seen, occurring only in patients with undiagnosed and/or extensive peripheral corneal involvement, each requiring repeat keratoplasty but with eventual cure of disease. Three of four patients experiencing graft failure not related to the original infection were regrafted with subsequently clear transplants. Of the patients not achieving 20/40 or better vision, two had vision limiting retinal disease and one deferred further transplantation.
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