Keratoplasty for Treatment of Acanthamoeba Keratitis

Kitzmann, Anna S.; Goins, Kenneth M.; Sutphin, John E.; Wagoner, Michael D.

doi:10.1016/j.ophtha.2008.12.029

Cited by 75 publications

(69 citation statements)

References 21 publications

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“…Kitzmann et al 17 reported that optical keratoplasty performed after resolution of active keratitis was associated with an excellent prognosis for both graft survival and visual outcome. In our cases, a median VA of 20/23 was obtained after optical keratoplasty, which is comparable to results reported by Kitzmann et al 17 One of the limitations of our study is that 15 of the 35 cases in this series were diagnosed clinically, in the face of a negative culture. Although the rate was similar to those discussed in previous reports, 1,3,6,7 fungal or bacterial infections were not completely excluded in culture negative patients as radial neuritis and ring infiltrates are not pathognomonic for AK, and antifungal or antibacterial medications could affect the results in these cases.…”

Section: Discussionsupporting

confidence: 86%

“…In addition, topical acyclovir ointment (n ¼ 19) and topical antibacterial agents (n ¼ 20) had been administered. At the initial visit, radial neuritis was observed in 17 The relationship between the base line characteristics, including prior treatment, culture positivity, and clinical features and initial VA was also evaluated with a regression analysis. As a result, the existence of ring infiltrate (Po0.01) and duration before diagnosis (Po0.01) were associated with initial VA.…”

Section: Clinical Featuresmentioning

confidence: 99%

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Visual outcome in Japanese patients with Acanthamoeba keratitis

Yamazoe

Yamamoto

Shimazaki-Den

et al. 2012

Eye

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Purpose To identify prognostic factors affecting visual outcome in Acanthamoeba keratitis (AK) treated with topical chlorhexidine gluconate (CHG). Methods A total of 35 eyes in 34 patients with AK were treated with 0.02% topical CHG. Patients were divided into two groups according to the final visual outcome: Group 1, final visual acuity (VA) of 20/25 or greater (22 eyes); Group 2, less than 20/25 (13 eyes). We compared these groups and evaluated the effectiveness of topical CHG compared with outcomes in previous reports. Results Ring infiltrate was observed more often in Group 2 (4.5% vs 61.5%, OR 33.6, 95% confidence interval (CI) 3.4-333.9, Po0.01). The duration between onset and diagnosis of AK was significantly longer (24.9 days vs 48.4 days, OR 1.03, 95% CI 1.00-1.06, P ¼ 0.04) and VA at initial examination (log MAR) significantly lower (0.47 vs 1.59, OR 25.5, 95% CI 3.4-186.7, Po0.01) in Group 2 (visual outcome o20/25). Multivariate analysis revealed that only VA at initial examination was independently associated with worse visual outcome (adjusted OR 24.5, 95% CI 1.9-312.6, P ¼ 0.01). Seventeen (85.0%) of the 20 eyes diagnosed within 1 month and 24 (82.8%) of 29 eyes diagnosed within 2 months achieved a VA of 20/40 or greater. Conclusion VA at initial examination was the most predictive factors for final visual outcome in AK. Topical CHG was comparably effective to other treatments, including polyhexamethyl biguanide and propamidine isethionate.

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Section: Discussionsupporting

confidence: 86%

Section: Clinical Featuresmentioning

confidence: 99%

Visual outcome in Japanese patients with Acanthamoeba keratitis

Yamazoe

Yamamoto

Shimazaki-Den

et al. 2012

Eye

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“…28 defects, and endophthalmitis were reported to occur after TKP. 30 Although it becomes necessary in the cases of corneal abscess or corneal perforation, therapeutic keratoplasty may cause several complications and graft failure, which was the case with our patients. 28,29 Accordingly, in the first case above, glaucoma and tissue rejection was observed, as TKP was performed in the acute period.…”

Section: Discussionmentioning

confidence: 61%

“…-30 Kitzmann et al has reported that multiple repeat keratoplasties (range, 2-6) were performed in 55% of the 22 eyes treated with TKP performed for AK. Recurrent AK, glaucoma, early and late persistent epithelial…”

mentioning

confidence: 99%

Contact Lens–Related Acanthamoeba Keratitis and Accompanying Dacryoadenitis

Şengör

Kurna

Altun

et al. 2015

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Despite the improvements in diagnostic tests and treatment strategies for AK, the role of prevention becomes apparent because of the bad prognosis of this serious complication; thus, contact lens wearers should be aware of the importance of using lenses under ophthalmologist's supervision. In addition, we would like to emphasize that AK may be frequently associated with lacrimal gland inflammation.

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“…Most recently, Kitzmann et al (Kitzmann et al, 2009) compared outcomes of 22 eyes with Acanthamoeba keratitis undergoing emergency penetrating or anterior lamellar keratoplasty and 9 eyes undergoing optical penetrating or anterior lamellar keratoplasty. Although all eyes ultimately achieved microbiological cure, there was a 41% recurrence rate of Acanthamoeba keratitis after emergency keratoplasty compared with 22% recurrence rate after optical keratoplasty.…”

Section: Therapeutic/optical Keratoplastymentioning

confidence: 99%