Use of Amniotic Membrane Transplant and Deep Anterior Keratoplasty in a Patient with Bilateral Acanthamoeba Infectious Keratitis: A Case Report
The aim of this study was to report a case with the use of amniotic membrane transplant and deep anterior keratoplasty in a patient with bilateral Acanthamoeba infectious keratitis as a treatment. A 20-year-old male presented with bilateral Acanthamoeba keratitis (AK) who was initially diagnosed wit...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-10-01
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| Series: | Case Reports in Ophthalmology |
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| Online Access: | https://beta.karger.com/Article/FullText/533988 |
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| author | Carlos A. Müller-Morales Guillermo Raul Vera-Duarte Valeria Oliva-Bienzobas Arturo Ramirez-Miranda Alejandro Navas Enrique O. Graue-Hernandez |
| author_facet | Carlos A. Müller-Morales Guillermo Raul Vera-Duarte Valeria Oliva-Bienzobas Arturo Ramirez-Miranda Alejandro Navas Enrique O. Graue-Hernandez |
| author_sort | Carlos A. Müller-Morales |
| collection | DOAJ |
| description | The aim of this study was to report a case with the use of amniotic membrane transplant and deep anterior keratoplasty in a patient with bilateral Acanthamoeba infectious keratitis as a treatment. A 20-year-old male presented with bilateral Acanthamoeba keratitis (AK) who was initially diagnosed with herpetic keratitis receiving full antiviral and corticosteroid topical treatment without any improvement. Corneal biopsy was performed to confirm the suspected diagnosis, and Acanthamoeba stromal cysts were identified in the sample. Treatment was initiated with 0.02% chlorhexidine, 0.1% propamidine isethionate, neomycin, and tropicamide/phenylephrine. Symptoms and clinical improvement were achieved between the 8th and 10th weeks, so corticosteroids were initiated. Treatment was continued until we observed a poor response in the left eye; therefore, an epithelial scraping and amniotic membrane placement were performed. Lately, the right eye underwent a deep anterior lamellar keratoplasty. A challenging case of bilateral AK managed with topical medications, amniotic membrane, and corneal keratoplasty. The earlier the disease is diagnosed, the better the outcome. If the diagnosis is delayed, the amoebas have penetrated deep into the corneal stroma, and successful therapy becomes difficult. A surgical option can be an early solution with a good prognosis for these cases. |
| first_indexed | 2024-03-11T10:15:23Z |
| format | Article |
| id | doaj.art-0d6e28ce518f4d23b8b23f240255ded4 |
| institution | Directory Open Access Journal |
| issn | 1663-2699 |
| language | English |
| last_indexed | 2024-03-11T10:15:23Z |
| publishDate | 2023-10-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Ophthalmology |
| spelling | doaj.art-0d6e28ce518f4d23b8b23f240255ded42023-11-16T07:58:21ZengKarger PublishersCase Reports in Ophthalmology1663-26992023-10-0114156857510.1159/000533988533988Use of Amniotic Membrane Transplant and Deep Anterior Keratoplasty in a Patient with Bilateral Acanthamoeba Infectious Keratitis: A Case ReportCarlos A. Müller-Morales0Guillermo Raul Vera-Duarte1Valeria Oliva-Bienzobas2Arturo Ramirez-Miranda3Alejandro Navas4Enrique O. Graue-Hernandez5Instituto De Oftalmologia Fundacion Conde De Valenciana FAP, Department of Cornea, External Diseases and Refractive Surgery, Mexico City, MexicoInstituto De Oftalmologia Fundacion Conde De Valenciana FAP, Department of Cornea, External Diseases and Refractive Surgery, Mexico City, MexicoInstituto De Oftalmologia Fundacion Conde De Valenciana FAP, Department of Cornea, External Diseases and Refractive Surgery, Mexico City, MexicoInstituto De Oftalmologia Fundacion Conde De Valenciana FAP, Department of Cornea, External Diseases and Refractive Surgery, Mexico City, MexicoInstituto De Oftalmologia Fundacion Conde De Valenciana FAP, Department of Cornea, External Diseases and Refractive Surgery, Mexico City, MexicoInstituto De Oftalmologia Fundacion Conde De Valenciana FAP, Department of Cornea, External Diseases and Refractive Surgery, Mexico City, MexicoThe aim of this study was to report a case with the use of amniotic membrane transplant and deep anterior keratoplasty in a patient with bilateral Acanthamoeba infectious keratitis as a treatment. A 20-year-old male presented with bilateral Acanthamoeba keratitis (AK) who was initially diagnosed with herpetic keratitis receiving full antiviral and corticosteroid topical treatment without any improvement. Corneal biopsy was performed to confirm the suspected diagnosis, and Acanthamoeba stromal cysts were identified in the sample. Treatment was initiated with 0.02% chlorhexidine, 0.1% propamidine isethionate, neomycin, and tropicamide/phenylephrine. Symptoms and clinical improvement were achieved between the 8th and 10th weeks, so corticosteroids were initiated. Treatment was continued until we observed a poor response in the left eye; therefore, an epithelial scraping and amniotic membrane placement were performed. Lately, the right eye underwent a deep anterior lamellar keratoplasty. A challenging case of bilateral AK managed with topical medications, amniotic membrane, and corneal keratoplasty. The earlier the disease is diagnosed, the better the outcome. If the diagnosis is delayed, the amoebas have penetrated deep into the corneal stroma, and successful therapy becomes difficult. A surgical option can be an early solution with a good prognosis for these cases.https://beta.karger.com/Article/FullText/533988acanthamoeba keratitisamniotic membrane transplantdeep anterior keratoplasty |
| spellingShingle | Carlos A. Müller-Morales Guillermo Raul Vera-Duarte Valeria Oliva-Bienzobas Arturo Ramirez-Miranda Alejandro Navas Enrique O. Graue-Hernandez Use of Amniotic Membrane Transplant and Deep Anterior Keratoplasty in a Patient with Bilateral Acanthamoeba Infectious Keratitis: A Case Report Case Reports in Ophthalmology acanthamoeba keratitis amniotic membrane transplant deep anterior keratoplasty |
| title | Use of Amniotic Membrane Transplant and Deep Anterior Keratoplasty in a Patient with Bilateral Acanthamoeba Infectious Keratitis: A Case Report |
| title_full | Use of Amniotic Membrane Transplant and Deep Anterior Keratoplasty in a Patient with Bilateral Acanthamoeba Infectious Keratitis: A Case Report |
| title_fullStr | Use of Amniotic Membrane Transplant and Deep Anterior Keratoplasty in a Patient with Bilateral Acanthamoeba Infectious Keratitis: A Case Report |
| title_full_unstemmed | Use of Amniotic Membrane Transplant and Deep Anterior Keratoplasty in a Patient with Bilateral Acanthamoeba Infectious Keratitis: A Case Report |
| title_short | Use of Amniotic Membrane Transplant and Deep Anterior Keratoplasty in a Patient with Bilateral Acanthamoeba Infectious Keratitis: A Case Report |
| title_sort | use of amniotic membrane transplant and deep anterior keratoplasty in a patient with bilateral acanthamoeba infectious keratitis a case report |
| topic | acanthamoeba keratitis amniotic membrane transplant deep anterior keratoplasty |
| url | https://beta.karger.com/Article/FullText/533988 |
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