title: Rapidly progressive cataract and iris atrophy during treatment of Acanthamoeba keratitis.
abstract: 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.
authors.affiliation: Sid W. Richardson Ocular Microbiology Laboratory, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Natasha L
authors.initials: NL
authors.lastname: Herz
authors.forename: Alice Y
authors.initials: AY
authors.lastname: Matoba
authors.forename: Kirk R
authors.initials: KR
authors.lastname: Wilhelmus
mesh_terms: 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
chemical_list: D000981:Antiprotozoal Agents; D001550:Benzamidines; D001645:Biguanides; D004202:Disinfectants; C031233:polihexanide; C018961:hexamidine; C046651:propamidine isethionate; C010882:chlorhexidine gluconate; D002710:Chlorhexidine