TREATMENT OF ACANTHAMOEBA KERATITIS BY CORNEAL CROSS-LINKING
Published 2022
- 26th ESCRS Winter Meeting
Reference: FP100
| Type: Abstracts
| DOI:
10.82333/6pkj-c188
Authors:
Yulduz Nizametdinova* 1
, Kirill Khripun 1
, Julia Ovchinnikova 1
1Ophthalmology microsurgery department №3,Saint Petersburg State Hospital No 2,Saint Petesburg,Russian Federation
Purpose
To describe the outcomes of multiple high fluence accelerated PACK-CXL (photo activated chromophore for keratitis) in treating of acanthamoeba keratitis with bacterial superinfection in patient who was allergic to all topical medication.
Setting
Microsurgery department No 3, State hospital No 2, Saint Petersburg, Russia.
Methods
A healthy 31-year old female presented with a severe unilateral keratitis. The acanthamoebic and bacterial etiology of infection was detected through the use of in vivo confocal microscopy (HRT). The infection was treated by anti-amoebic, antibacterial and anti-inflammatory medications. Clinical presentation was complicated with significant allergic response to all of them. To decrease these signs and stimulate curing we reduced the amount of topical therapy and used procedures of PACK-CXL. That included two accelerated PACK-CXL (20 mW/cm2 4 min 30 sec, total fluence 5.4 J/cm2) and three accelerated high fluence PACK-CXL (30 mW/cm2 4 min, total fluence 7.2 J/cm2).
Results
In this case of advanced acanthamoeba keratitis with bacterial superinfection five procedures of accelerated PACK-CXL led to pain relief and total epithelization of corneal defects during 5 months with minimal using of topical anti-amoebic and anti-inflammatory therapy.
Conclusion
High fluence accelerated PACK-CXL (30 mW/cm2 for 4 min, total fluence 7.2 J/cm2) show the most significant effects. It might be a useful method for treating acanthamoeba keratitis associated with bacterial infection.