Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)

Background: The diagnosis of acanthamoeba keratitis has increased since 1985 due to the massive use of contact lenses and a better knowledge of the disease by ophthalmologists. The use of biassociated therapy has resulted in a better prognosis and lower complication rate. Aim: To report patients wit...

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Autores principales:	Donoso R,Rodrigo, Mura C,Juan José, López M,Mauricio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2002
Materias:	Acanthamoeba keratitis Contact lenses Polyhexamethylbiguanide Propamidine
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000400006
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spelling	oai:scielo:S0034-988720020004000062003-01-24Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)Donoso R,RodrigoMura C,Juan JoséLópez M,Mauricio Acanthamoeba keratitis Contact lenses Polyhexamethylbiguanide Propamidine Background: The diagnosis of acanthamoeba keratitis has increased since 1985 due to the massive use of contact lenses and a better knowledge of the disease by ophthalmologists. The use of biassociated therapy has resulted in a better prognosis and lower complication rate. Aim: To report patients with acanthamoeba keratitis treated with the association of propamidine (Brolene(r)) and polyhexamethylbiguanide (PHMB) 0.02%. Patients and methods: Retrospective analysis of 27 patients (31 eyes) with acanthamoeba keratitis (bilateral in four cases), diagnosed by culture, biopsy or characteristic clinical features. Results: Ninety six percent of patients used rigid contact lenses. Acanthamoeba cultures were positive in 71% of cases. The delay in the diagnosis was between 1 and 5 months. Early treatment was possible in 29% of patients. Infection was erradicated in all cases with the biassociated therapy. A tectonic keratoplasty to treat a trophic perforation was done in eight eyes. No patient required therapeutic keratoplasty to resolve the infection. Visual acuity at the end of follow up was better than 20/40 in nine patients and in eight it was in the range of count fingers or less. Conclusions: In patients with the clinical picture of acanthamoeba keratitis, early or late antiamoebic treatment is warranted even in the absence of positive cultures. The visual results of the treatment are highly dependent on the precocity of treatment. Prevention is imperative and is based on a strict contact lens hygiene (Rev Méd Chile 2002; 130: 396-401)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.130 n.4 20022002-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000400006es10.4067/S0034-98872002000400006
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Acanthamoeba keratitis Contact lenses Polyhexamethylbiguanide Propamidine
spellingShingle	Acanthamoeba keratitis Contact lenses Polyhexamethylbiguanide Propamidine Donoso R,Rodrigo Mura C,Juan José López M,Mauricio Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)
description	Background: The diagnosis of acanthamoeba keratitis has increased since 1985 due to the massive use of contact lenses and a better knowledge of the disease by ophthalmologists. The use of biassociated therapy has resulted in a better prognosis and lower complication rate. Aim: To report patients with acanthamoeba keratitis treated with the association of propamidine (Brolene(r)) and polyhexamethylbiguanide (PHMB) 0.02%. Patients and methods: Retrospective analysis of 27 patients (31 eyes) with acanthamoeba keratitis (bilateral in four cases), diagnosed by culture, biopsy or characteristic clinical features. Results: Ninety six percent of patients used rigid contact lenses. Acanthamoeba cultures were positive in 71% of cases. The delay in the diagnosis was between 1 and 5 months. Early treatment was possible in 29% of patients. Infection was erradicated in all cases with the biassociated therapy. A tectonic keratoplasty to treat a trophic perforation was done in eight eyes. No patient required therapeutic keratoplasty to resolve the infection. Visual acuity at the end of follow up was better than 20/40 in nine patients and in eight it was in the range of count fingers or less. Conclusions: In patients with the clinical picture of acanthamoeba keratitis, early or late antiamoebic treatment is warranted even in the absence of positive cultures. The visual results of the treatment are highly dependent on the precocity of treatment. Prevention is imperative and is based on a strict contact lens hygiene (Rev Méd Chile 2002; 130: 396-401)
author	Donoso R,Rodrigo Mura C,Juan José López M,Mauricio
author_facet	Donoso R,Rodrigo Mura C,Juan José López M,Mauricio
author_sort	Donoso R,Rodrigo
title	Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)
title_short	Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)
title_full	Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)
title_fullStr	Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)
title_full_unstemmed	Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)
title_sort	queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (phmb)
publisher	Sociedad Médica de Santiago
publishDate	2002
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002000400006
work_keys_str_mv	AT donosorrodrigo queratitisporacantoamoebatratadasconpropamidinaypolihexametilbiguanidaphmb AT muracjuanjose queratitisporacantoamoebatratadasconpropamidinaypolihexametilbiguanidaphmb AT lopezmmauricio queratitisporacantoamoebatratadasconpropamidinaypolihexametilbiguanidaphmb
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Queratitis por acantoamoeba tratadas con propamidina y polihexametil biguanida (PHMB)

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