Effect of Amoebicidal Agents on the Human Corneal Keratocytes in Vitro

PURPOSE: To evaluate the effect of polyhexamethylene biguanide (PHMB) and chlorhexidine on Acanthamoeba cysts and cultured human keratocytes. METHODS: Each well of two-fold diluted PHMB and chlorhexidine were treated on the Acanthamoeba cyst suspension of 5 x 10(4) cysts/ml for 8, 24, and 48 hours to measure the minimal cysticidal concentration (MCC) of each disinfectant and was exposed to the human corneal keratocytes of 5 x 10(4) cells/ml for same hours to measure the survival rate of keratocytes. Inverted phase-contrast micrograph and electron microscopy for observing the morphologic changes were evaluated. RESULTS: MCC of PHMB was 9.42 microgram/ml, 5.62 microgram/ml, and 2.37 microgram/ml, and chlorhexidine was 24.32 microgram/ml, 10.02 microgram/ml, and 7.02 microgram/ml respecitvely in 8, 24, and 48 hours. The survival rate of keratocytes at MCC was 91.7%, 64.6%, and 49.7% in PHMB of which significant decreases were found at 24 and 48 hours, and 95.7%, 90.6%, and 78.1% in chlorhexidine of which significant decrease was only found at 48 hours. The higher the concentration of disinfectants, cysts and keratocytes demonstrated more damaged appearance. CONCLUSIONS: The amoebicidal efficacy of PHMB and chlorhexidine was similar. However, in consideration of toxic effect on keratocytes by disinfectants, chlorhexidine is suggested to be more clinically useful than PHMB.

Evaluation of Cysticidal Effects of Contact Lens Disinfectant on Acanthamoeba Isolates

PURPOSE: To evaluate the cysticidal effect of 5 kinds of commercially available contact lens disinfectants against 2 clinical isolates of Acanthamoeba. METHODS: Five kinds of commercially available contact lens disinfectants were soaked with cysts of Acanthamoeba ludgdunesis and castellanii at the concentration of 10(3), 10(4), and 10(5) cells/ml for 1 and 4 or 6 hours. Cysts which were not excysted in 7 days after treatment were recognized to be killed. Morphologic changes were evaluated by electron microscopic observation. RESULTS: Contact lens disinfectants which contain myristamidopropyl dimethylamine (MAPD) showed the best cysticidal effect. These disinfectants demonstrated a cysticidal effect on both Acanthamoeba species of all concentrations in 6-hour treatment. Contact lens disinfectants which contain polyhexamethylene biguanide (PHMB) did not demonstrate cysticidal effect, except for Acanthamoeba castellanii at the concentration of 10(3) cells/ml, in either 4- or 6-hour treatment. Separation of plasma membrane from endocyst and damage of organelles were prominent in cases showing a cysticidal effect. CONCLUSIONS: Contact lens disinfectant which contains MAPD may be helpful in preventing the Acanthamoeba keratitis. A higher concentration of PHMB is required to be effective in preventing Acanthamoeba keratitis.