title: Treatment of acanthamoeba keratitis with chlorhexidine.
abstract: OBJECTIVE
  To evaluate the efficacy of chlorhexidine solution in the treatment of patients with Acanthamoeba keratitis.
  
  
  METHODS
  Prospective nonrandomized study.
  
  
  METHODS
  Five patients infected with culture-proven Acanthamoeba keratitis.
  
  
  METHODS
  Chlorhexidine solution was used hourly on six eyes and gradually reduced to four times a day after 1 month. Follow-up ranged from 1 to 10 months (mean, 4 months).
  
  
  METHODS
  Severity of symptoms and signs, time for healing, and final visual acuity.
  
  
  RESULTS
  Clinical results in four patients showed improved visual acuity, with a rapid recovery within 1 week. No adverse drug reaction was encountered, but one patient with a perforated ulcer developed glaucoma. Eighty-three percent of 6 eyes were medically cured with chlorhexidine and recovered visual acuity 6/18 or better. Four of five patients improved within 3 weeks, with resolution of infiltration and healing of epithelial defects. By 2 to 3 weeks, visual acuity 6/18 or better had improved in four (66.7%) of six eyes and recovered 6/6 in two eyes (33.3%). Bacterial coinfection occurred in one eye.
  
  
  CONCLUSIONS
  Chlorhexidine dramatically hastened clinical improvement in all eyes and is a successful medical therapy that has excellent results in patients who are diagnosed early.
authors: Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors: P
authors: P
authors: Kosrirukvongs
authors: D
authors: D
authors: Wanachiwanawin
authors: G S
authors: GS
authors: Visvesvara
mesh_terms: D000048:Acanthamoeba / Q000302:isolation & purification; D015823:Acanthamoeba Keratitis / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000818:Animals; D000891:Anti-Infective Agents, Local / Q000009:adverse effects / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000009:adverse effects / Q000627:therapeutic use*; D003315:Cornea / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D000891:Anti-Infective Agents, Local; D009883:Ophthalmic Solutions; D002710:Chlorhexidine