Prognostic Factors For Corneal Transplantation In Acanthamoeba Keratitis: A Retrospective Study
Published 2025 - 43rd Congress of the ESCRS
Reference: FP23.10 | Type: Free paper | DOI: 10.82333/q8pp-9q81
Authors: Francesca Pilati* 1 , Erika Bonacci 2 , Camilla Pagnacco 1 , Clara Rizzo 1 , Andrea Benetti 1 , Giovanni Bellisario 1 , Francesca Barzaghi 1 , Arianna Serraiotto 1 , Diletta Micochero 1 , Luca Polinelli 1 , Giorgio Marchini 1 , Emilio Pedrotti 1
1Opthalmology Clinic, Department of Surgery, Dentistry, Maternity and Infant,University of Verona,Verona,Italy, 2Department of Engineering for Innovation Medicine,University of Verona,Verona,Italy
Purpose
To analyze clinical findings and prognostic factors associated with visual and morphological outcomes in patients with Acanthamoeba keratitis (AK).
Setting
Single-center, retrospective, longitudinal study of 51 cases of AK diagnosed by real-time polymerase chain reaction (RT-PCR) between March 2010 and October 2022.
Methods
The primary outcome was the need for corneal transplant. Clinical and demographic characteristics, anti-Acanthamoeba treatment, and disease complications were compared between transplant and non-transplant groups. Early diagnosis was defined as <= 14 days from symptom onset to treatment initiation. Multivariable logistic regression was performed to identify predictors for corneal transplant.
Results
The mean follow-up was 39.0 ± 30.2 months (range: 14–120). Corneal transplant was required in 18 eyes (35.3%), which had worse initial best-corrected visual acuity (BCVA) (1.75 ± 0.6 vs. 0.55 ± 0.47 logMAR, p<=0.001), higher prevalence of ring infiltrates (67% vs. 18.2%, p<=0.001), and ring ulcers (38.9% vs. 9.1%, p = 0.01). Eight eyes (44.4%) required re-transplantation, with 12 eyes (23.5%) undergoing evisceration/enucleation (4 in the transplant group vs. 8 in the non-transplant group, p = 0.579). In multivariable analysis, only worse initial BCVA was independently associated with the need for corneal transplant (OR = 17.5; 95% CI: 3.67–83.56, p<= 0.001).
Conclusions
Corneal transplant was required in 35.3% of AK cases. Worse initial BCVA was the only significant predictor for corneal transplantation.