J Korean Ophthalmol Soc.  2015 Feb;56(2):280-284. 10.3341/jkos.2015.56.2.280.

Two Cases of Corneal Toxicity in Acanthamoeba Keratitis by Combined Topical Anti-Acanthamoeba Keratitis Eye Solution

• Lee JK
• Lee JS

• KMID: 2216014
• DOI: http://doi.org/10.3341/jkos.2015.56.2.280

Abstract

PURPOSE
To present a case of corneal toxicity caused by therapeutic duplication during treatment of acanthamoeba keratitis as a complication of contact lens use.
CASE SUMMARY
A 12-year-old girl with a history of wearing orthokeratology contact lenses and a 14-year-old girl with a history of wearing cosmetic contact lenses presented with ocular pain, injection, and decreased visual acuity. They were diagnosed as having acanthamoeba keratitis based on slit lamp examination, confocal microscopy and culture. After the patients were treated with polyhexamethylene biguanide (PHMB) and chlorhexidine, corneal epithelial defect and erosion occurred. Use of chlorhexidine was stopped, and PHMB was used to treat patients and recovery of the corneal epithelium with improvement in symptoms of acanthamoeba keratitis was found.
CONCLUSIONS
Using PHMB and chlorhexidine together in treating acanthamoeba keratitis increases the risk of corneal toxicity. Therefore, these drugs should be avoided in combination.

Keyword

Acanthamoeba; Chlorhexidine; Human corneal keratocyte; Polyhexamethylene biguanide

MeSH Terms

Acanthamoeba
Acanthamoeba Keratitis*
Adolescent
Child
Chlorhexidine
Contact Lenses
Epithelium, Corneal
Female
Humans
Keratitis*
Microscopy, Confocal
Visual Acuity
Chlorhexidine