Accelerated collagen cross-linking in the management of advanced Acanthamoeba keratitis

Arq Bras Oftalmol. 2019 Mar-Apr;82(2):103-106. doi: 10.5935/0004-2749.20190018. Epub 2019 Jan 10.

Abstract

Purpose: To report our initial experience in the treatment of Acanthamoeba keratitis with accelerated corneal collagen cross-linking.

Methods: Retrospective chart review of patients diagnosed with Acanthamoeba keratitis with progressive corneal melting who were treated with accelerated collagen cross-linking.

Results: A total of 6 eyes (5 patients) were reviewed. All the patients received adjuvant therapy with moxifloxacin and chlorhexidine. In 4 cases, the ulcer healed with a mean interval to epithelialization of 108.8 days (range 59-217). In 2 eyes, there was a persistent neurotrophic ulcer. The melting was not progressive in any case, nor did any eye required emergency penetrating keratoplasy.

Conclusion: This study suggests a beneficial effect of accelerated collagen cross-linking in cases of Acanthamoeba keratitis with corneal melting. Thus, collagen cross-linking may be considered as adjuvant treatment for Acanthamoeba keratitis.

Publication types

  • Evaluation Study

MeSH terms

  • Acanthamoeba Keratitis / metabolism
  • Acanthamoeba Keratitis / therapy*
  • Aged
  • Aged, 80 and over
  • Collagen / drug effects
  • Collagen / metabolism*
  • Collagen / radiation effects
  • Cornea / drug effects
  • Cornea / metabolism
  • Cornea / radiation effects
  • Corneal Ulcer / metabolism
  • Corneal Ulcer / therapy
  • Cross-Linking Reagents / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Photosensitizing Agents / therapeutic use*
  • Reproducibility of Results
  • Retrospective Studies
  • Riboflavin / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Ultraviolet Therapy / methods*

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin