Findings in 2 Cases of Acanthamoeba Keratitis.
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Accession number;04A0276146
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| Title;Findings in 2 Cases of Acanthamoeba Keratitis. |
| Author;
SASAKI KAORU
(Kumamoto Univ., Graduate School, JPN)
YOSHIDA MINORU
(Kikkokai Tane Memorial Eye Hospital, JPN)
HARUTA YASUTERU
(Sankeikai Harutaganka Bun'in)
MANO TOMIYA
(Kikkokai Tane Memorial Eye Hospital, JPN)
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Journal Title;Journal of the Eye
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Journal Code:Y0754A
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ISSN:0910-1810
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VOL.21;NO.3;PAGE.379-383(2004)
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| Figure&Table&Reference;FIG.9, REF.26 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Two cases of Acanthamoeba keratitis, both classified in the initial or transient stage, were successfully treated with two corneal debridement. In Japan, combined therapy with total and local administration of antifungal drug, and corneal debridement, is strongly recommended. Among them, Ishibashi et al. emphasize the importance of repeated corneal debridement. In Europe and North America, however, combined administration of polyhexamethylene biguanide (PHMB), Brolene and fradiomycin is recognized as standard therapy; they do not give special attention to the corneal debridement. We successfully treated two cases of Acanthamoeba keratitis, with few times debridement. Both cases were 27 year-old female soft contact lens wearers. Case 1 was diagnosed as herpetic keratitis or bacterial keratitis at first visit, and adequate therapy was delayed. The keratitis progressed into the ring-like infiltration form. Although Acanthamoeba was not isolated, we diagnosed Acanthamoeba keratitis on the basis of clinical observation. The patient was treated with antifungal drug; the treatment was successful in 3 months. In case 2, the pathogen Acanthamoeba was isolated at an early time point. The patient was treated with antifungal drug and chlorhexidine and healed to good transparency in 3 months. The corneal debridement was restricted to twice in both cases, for the following 4 reasons: 1, the patient's physiological and mental pain; 2, instability of debridement effectiveness; 3, corneal thinning caused by debridement; and 4, loss of final transparency due to debridement. Another problem is its cost. Although there were additional minor problems, such as long healing time, both cases successfully healed to good visual acuity without repeated debridement (Best corrected visual acuity was 20/20 in both cases). We conclude that some cases of Acanthamoeba keratitis in the initial stage can be treated with only few times debridement. (author abst.) |
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