Novel Effective Medical Therapy for Acanthamoeba Keratitis

Eye Contact Lens. 2024 Jun 1;50(6):279-281. doi: 10.1097/ICL.0000000000001092. Epub 2024 May 1.

Abstract

Purpose: To report first clinical use of novel medical treatment for Acanthamoeba keratitis.

Methods: Interventional observational case series. Two patients with Acanthamoeba keratitis were unsuccessfully treated with polihexanide (PHMB) 0.02% and propamidine 0.1% for 6 weeks, then all were shifted in a compassionate use of PHMB 0.08% with novel standardized protocol. The postinterventional follow-up of patients was at least 7 months.

Results: PHMB 0.08% eyedrops in a novel standardized protocol improved infection resolution and led to complete healing of the lesion after 4 weeks in the two cases. Corneal opacities and neovascularization decreased slowly, best-corrected visual acuity slightly improved and progressively increased in the further 7 months, and no infection recurrence occurred.

Conclusions: This preliminary report of two cases shows promising response to polihexanide 0.08% lowering drastically the illness duration, with reduced chance of recurrence, and mostly improving patients' quality of life.

Publication types

  • Case Reports
  • Observational Study

MeSH terms

  • Acanthamoeba Keratitis* / drug therapy
  • Adolescent
  • Adult
  • Antiprotozoal Agents / therapeutic use
  • Benzamidines / therapeutic use
  • Biguanides* / therapeutic use
  • Female
  • Humans
  • Male
  • Ophthalmic Solutions
  • Visual Acuity

Substances

  • Antiprotozoal Agents
  • Benzamidines
  • Biguanides
  • Ophthalmic Solutions
  • polihexanide
  • propamidine