OBJECTIVE: To evaluate the efficacy of chlorhexidine solution in the treatment of patients with Acanthamoeba keratitis. DESIGN: Prospective nonrandomized study. PARTICIPANTS: Five patients infected with culture-proven Acanthamoeba keratitis. INTERVENTION: 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). MAIN OUTCOME MEASURES: 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. CONCLUSION: Chlorhexidine dramatically hastened clinical improvement in all eyes and is a successful medical therapy that has excellent results in patients who are diagnosed early.
OBJECTIVE: To evaluate the efficacy of chlorhexidine solution in the treatment of patients with Acanthamoeba keratitis. DESIGN: Prospective nonrandomized study. PARTICIPANTS: Five patients infected with culture-proven Acanthamoeba keratitis. INTERVENTION: 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). MAIN OUTCOME MEASURES: 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. CONCLUSION: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: Jeena Mascarenhas; Prajna Lalitha; N Venkatesh Prajna; Muthiah Srinivasan; Manoranjan Das; Sean S D'Silva; Catherine E Oldenburg; Durga S Borkar; Elizabeth J Esterberg; Thomas M Lietman; Jeremy D Keenan Journal: Am J Ophthalmol Date: 2013-11-05 Impact factor: 5.258