Rapidly progressive cataract and iris atrophy during treatment of Acanthamoeba keratitis.
OBJECTIVE
To identify characteristics associated with cataract occurring during the course of Acanthamoeba keratitis.


METHODS
Retrospective observational case series.


METHODS
Eighty-one laboratory-confirmed patients with Acanthamoeba keratitis.


METHODS
Review of clinical records.


METHODS
Development of cataract during management of Acanthamoeba keratitis.


RESULTS
Rapidly progressive crystalline lens opacification occurred in 9 eyes within 4 to 15 weeks after diagnosis of Acanthamoeba keratitis. Three were associated with inflammatory complications, including anterior scleritis (2 eyes) and iridocyclitis (1 eye). Six others had the abrupt onset of a dense cataract, including 5 with iris atrophy, that occurred during the initial 6 months of therapy with chlorhexidine, a diamidine, and adjunctive corticosteroid. Extracapsular cataract extraction was performed with or after penetrating keratoplasty. Secondary glaucoma developed in 6 of 9 eyes subsequent to iris atrophy (4 eyes) or a cyclitic membrane (2 eyes), and 3 eyes underwent trabeculectomy.


CONCLUSIONS
Cataract may occur and progress during the management of Acanthamoeba keratitis in association with anterior segment inflammation, iris atrophy, and secondary glaucoma.
Herz
Natasha L
NL
Sid W. Richardson Ocular Microbiology Laboratory, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.
Matoba
Alice Y
AY
Wilhelmus
Kirk R
KR
D015823:Acanthamoeba Keratitis / Q000188:drug therapy*; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000981:Antiprotozoal Agents / Q000009:adverse effects*; D001284:Atrophy / Q000139:chemically induced; D001550:Benzamidines / Q000009:adverse effects; D001645:Biguanides / Q000009:adverse effects; D002386:Cataract / Q000139:chemically induced*; D002387:Cataract Extraction; D002710:Chlorhexidine / Q000009:adverse effects / Q000031:analogs & derivatives; D018450:Disease Progression; D004202:Disinfectants / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005901:Glaucoma / Q000209:etiology / Q000601:surgery; D006801:Humans; D007498:Iris / Q000187:drug effects* / Q000473:pathology*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014130:Trabeculectomy
D000981:Antiprotozoal Agents; D001550:Benzamidines; D001645:Biguanides; D004202:Disinfectants; C031233:polihexanide; C018961:hexamidine; C046651:propamidine isethionate; C010882:chlorhexidine gluconate; D002710:Chlorhexidine