Successful medical management of Acanthamoeba keratitis.
Seven patients with documented Acanthamoeba keratitis were treated with prolonged and intensive triple antiamoebic therapy consisting of topical neomycin-polymyxin B-gramicidin, propamidine isethionate 0.1%, and miconazole nitrate 1%. Additionally, five patients were treated with topical corticosteroids. Six of seven patients were cured of Acanthamoeba keratitis with medical therapy alone, one patient required therapeutic penetrating keratoplasty to eradicate the infection. Two patients underwent penetrating keratoplasty to improve their vision after medical therapy. Our series differs from previous reports in that triple antiamoebic therapy was used in all seven patients and was successful in both early and advanced cases of Acanthamoeba keratitis. Prolonged and intensive topical therapy with these three antiamoebic drugs may be an effective mode of therapy for Acanthamoeba keratitis.
Berger
S T
ST
Ocular Inflammatory Disease Center, Jules Stein Eye Institute, Los Angeles, CA.
Mondino
B J
BJ
Hoft
R H
RH
Donzis
P B
PB
Holland
G N
GN
Farley
M K
MK
Levenson
J E
JE
D000287:Administration, Topical; D000328:Adult; D000562:Amebiasis / Q000188:drug therapy / Q000628:therapy; D000563:Amebicides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016039:Corneal Transplantation; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007634:Keratitis / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged
D000563:Amebicides; D000900:Anti-Bacterial Agents