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Early keratoplasty in patient with Acanthamoeba keratitis: clinical case

Poster Details

First Author: E.Usubov RUSSIA

Co Author(s):    M. Bikbov   V. Surkova   K. Oganisyan              

Abstract Details

Purpose:

To evaluate the clinical and functional results of early keratoplasty by the clinical example of Acanthamoeba keratitis

Setting:

The patient admitted to Ufa Eye Research Institute with a diagnosis: OS - Keratitis of unknown ethiology with the threat of perforation. OU - moderate myopia.

Methods:

Admission visual acuity of the left eye with a maximum correction was (CVA) - 0.05. The local anti-inflammatory and anti-microbial treatment was prescribed. However, negative dynamic was observed on the background of the therapy. Objective examinations of OS: UNVA - 0,005. Chemosis, conjunctival hyperemia, edematous cornea, infiltration of 5x5 mm was observed in the upper area, the cornea thinned in the center of focus, 1x1 mm descemetocele. Confocal microscopy identified subepithelially and stromally located Acanthamoeba cysts, density - hyperechoic. Penetrating keratoplasty was recommended for medical and optical purpose.

Results:

Penetrating keratoplasty with a continuous suture was performed. Donor graft was 7 mm, the recipient bed - 6.75 mm. Anti-inflammatory treatment was prescribed. Antiparasitic treatment was continued after the surgery, and the locally Cyclosporin A was assigned, antibiotics and antiprotozoal drugs, corticosteroids according to the schedule. The postoperative course was areactive, UCVA increased to 0.09. After 6 months transplant remained transparent, sutures were consistent. Density of endothelial cells in the central part of the graft was 1874 ± 25 cells/mm², extracellular matrix is completely transparent. Visual acuity of the operated eye was 0.4, with a best correction sph+2,5D - 0.5.

Conclusions:

Early optic keratoplasty combined with adequate cytostatic and immunosuppressive therapy is reasonable and effective treatment for Acanthamoeba keratitis.

Financial Disclosure:

NONE

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