Are cataract and iris atrophy toxic complications of medical treatment of acanthamoeba keratitis?
OBJECTIVE
Two cases of acanthamoeba keratitis with almost identical clinical courses developed mature cataract and iris atrophy after prolonged treatment with chlorhexidine 0.02% and propamidine isethionate 0.1%. It is suggested that these complications were caused by the chemicals, rather than resulting from the amoebae-induced inflammation.


METHODS
Penetrating keratoplasty was performed in both cases when perforation from peripheral ulceration was threatening.


CONCLUSIONS
The immediate results were good. From these two cases it seems possible that there is a maximum level of intensity of the medical treatment and also that surgery should be considered at an earlier stage, before intraocular complications develop.
Ehlers
Niels
N
Department of Ophthalmology, Arhus University Hospital, Arhus, Denmark. neh@akh.aaa.dk
Hjortdal
Jesper
J
D015823:Acanthamoeba Keratitis / Q000188:drug therapy*; D000981:Antiprotozoal Agents / Q000009:adverse effects*; D001284:Atrophy; D001550:Benzamidines / Q000009:adverse effects*; D002386:Cataract / Q000139:chemically induced*; D002387:Cataract Extraction; D002710:Chlorhexidine / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007498:Iris / Q000187:drug effects*; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D014792:Visual Acuity
D000981:Antiprotozoal Agents; D001550:Benzamidines; C046651:propamidine isethionate; D002710:Chlorhexidine