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Kanno Okamura, Tsuyoshi Oshio, Eiichi Uchio; Treatment outcome of acanthamoeba keratitis in the last decade. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6495.
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Acanthamoeba keratitis (AK) is a refractory inflammatory disorder which often requires intensive treatment measures and it prolongs for a long period of hospitalization. The major accepted treatment is composed of local and systemic antifungal agents, local disinfectants and repeated corneal scrapings. There is a controversy in the indication of surgical treatment for AK. In this study, we analyzed medical and surgical treatment outcome of recent case series of AK at our hospital in the last decade.
Twenty-three cases (11men and 12 women) who were treated at Fukuoka University Hospital from 2008 to 2018 were enrolled in this study and their backgrounds, clinical findings, treatment measures and visual prognosis were evaluated.
All patients were contact lens wearers (soft contact lens 21 cases and hard contact lens 2 cases, respectively). Acanthamoeba was isolated in 12 cases (52%) and other cases were diagnosed based on typical clinical findings. All cases were treated with combination of local and systemic antifungal drugs, disinfectant eye drops (0.02% chlorhexidine) and corneal scrapings. We used pentamidine isethionate infusion for additional treatment in 21 cases (91%). In spite of these treatment, six cases (26%) hardly responded medical therapy and therapeutic keratoplasty was carried out. Air-assisted manual deep lamellar keratoplasty was done in all cases without any intraoperative or postsurgical complications. Best corrected postsurgical visual acuity was more than 16/20 in all cases including surgically treated eyes. Average length of hospital stay was 25 days. No case showed recurrence of AK after their treatment.
It is suggested that treatment outcome of combination therapy for AK was effective recently. Surgical treatment showed excellent outcome in serious AK cases that were resistant to combination therapy with a favorable visual prognosis and resulted in considerable shortening of treatment duration.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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