The Authors present 7 patients affected by Acanthamoeba keratitis referred to their Division between 1993-'97. The patients were 4 males an 3 females with a mean age of 25.5 years (range 14-47). Six subjects suffered of myopia and wore soft contact lenses (SCL), while the seventh patient, emmetropic, used a therapeutic lens because affected by evoluted Fuchs dystrophy. The most important risk factor to acquire the infection is represented by repeated contacts with tap water wearing the SCL. Signs and symptoms included photophobia, ocular pain, conjunctival hyperemia and decrease of visual acuity, mimicking in three cases an herpetic keratitis with delay of weeks and months in the etiological diagnosis and use of incongruous therapies. In all cases Acanthamoeba keratitis was clinically suspected and confirmed by the direct identification of cysts and trophozoites in scraping or corneal biopsy or by in vitro isolation of the strains. Drug treatment, prolonged for some months, cleared the infection in 5/7 patients, while in 2 patients it was needed to perform a penetrating keratoplasty (PK) because of their severe and advanced pathological stage when they referred to our Division. During the follow up (range 4-48 months) we observed an Acanthamoeba reinfection only in one patient (one of the 2 patients in which was performed a PK) that quickly clarified with medical treatment. In conclusion, the early diagnosis combined with the available of new drugs allowed to improve the prognosis of the Acanthamoeba keratitis, often allowing the restore of a good visual function after only a useful medical treatment.
|Translated title of the contribution||Our experience in the treatment of Acanthamoeba keratitis|
|Number of pages||5|
|Journal||Acta Medica Romana|
|Publication status||Published - 1998|
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