PURPOSE: To report the efficacy of phototherapeutic keratectomy (PTK) and deep lamellar keratoplasty (DLKP) in the treatment of Acanthamoeba keratitis. METHODS: Two patients with delayed diagnosis of Acanthamoeba keratitis failed to respond to multiple systemic and topic antiamoebic agents supplemented by twice-weekly corneal scraping. Three weeks into such therapy, one developed a ring-shaped subepithelial infiltration and PTK was performed. The other was treated with DLKP for progressive keratitis that had invaded the midstromal layer after 50 days of medical therapy. RESULTS: Improvements were observed immediately after the operations and medical therapy was gradually discontinued. Best-corrected visual acuity improved to 20/20 for both patients. CONCLUSIONS: PTK and DLKP were found to be effective surgical procedures, especially for advanced Acanthamoeba keratitis that fails to respond to medical therapy and corneal debridement.
PURPOSE: To report the efficacy of phototherapeutic keratectomy (PTK) and deep lamellar keratoplasty (DLKP) in the treatment of Acanthamoeba keratitis. METHODS: Two patients with delayed diagnosis of Acanthamoeba keratitis failed to respond to multiple systemic and topic antiamoebic agents supplemented by twice-weekly corneal scraping. Three weeks into such therapy, one developed a ring-shaped subepithelial infiltration and PTK was performed. The other was treated with DLKP for progressive keratitis that had invaded the midstromal layer after 50 days of medical therapy. RESULTS: Improvements were observed immediately after the operations and medical therapy was gradually discontinued. Best-corrected visual acuity improved to 20/20 for both patients. CONCLUSIONS: PTK and DLKP were found to be effective surgical procedures, especially for advanced Acanthamoeba keratitis that fails to respond to medical therapy and corneal debridement.