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A. W. Jachens, D. S. Chu; Analyzing the Course, Treatment, Outcome and Risk Factors of Acanthamoeba Keratitis Patients. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5524.
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To review the course, treatment and outcome of Contact lens associated acanthamoeba keratitis patients as well as their contact lens cleaning and storage habits for risk factors contributing to their infection.
We conducted a retrospective chart review of all patients treated for laboratory test proven acanthamoeba keratitis between August 2001 and November 2007 at the Institute of Ophthalmology and Visual Science at the University of Medicine and Dentistry of New Jersey recording their disease course, treatments, surgeries and current outcome. We also surveyed the available patients assessing their contact lens cleaning and storage habits as well as any risk factors for the infection.
The nine patients included in the study consisted of five males and four females, all soft contact lens users. Six patients underwent a corneal transplant with three achieving successful results. Of the three patients who did not require corneal transplant, two of the patients’ infection resolved with pharmacologic treatment and one was lost to follow up shortly after diagnosis. The majority of transplants performed during infection failed whereas the majority of those performed after the infection resolved were successful. The average time between diagnosis and transplant was 8 months. Of the five surveyed, four showered and three swam in swimming pools wearing their lenses, two cleaned and stored their lenses in tap water, two would regularly top off their storage solution and one would change the storage solution infrequently. The surveyed patients used a variety of five different brands of all purpose solution and all were of the "no rub" variety.
Acanthamoeba keratitis is a severe and difficult to treat infection commonly associated with soft contact lens use. The majority of our patients necessitated corneal transplants with those done after resolution of infection providing more successful results. Every patient was a soft contact lens user and had significant risk factors for infection due to their lens maintenance habits. Although we found no common brand of all purpose solution throughout the cases, all the solutions were "no rub" which may be a factor in this infection.
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