[Three cases of Acanthamoeba keratitis [AK] in Yazd]

ABSTRACT

Acanthamoeba keratitis is a vision- threatening infection and the most important risk factors are contact lenses Characteristic symptoms include disproportionately severe ocular pain, epithelial ulcer, ring stromal infiltrate and resistance to antimicrobial treatment. The aim is to report the first cases of Acanthamoeba keratitis in Yazd in a retrospective study confirmed on histopathological and confocal microscopy. All of our patients used soft contact lenses and were women. The age range was between 20-29 years. One eye was`misdiagnosed as herpes simplex keratitis and two were misdiagnosed as bacterial keratitis. A delayed visit as well as a late diagnosis led to the advanced stage of eye disease. Improvement in visual acuity following medical therapy was seen in two patients and one patient needed urgent keratoplasty for corneal necrosis A prompt clinical and laboratory diagnosis along with treatment with propamidine- isentionate resulted in significant improvement of eye condition Failure to disinfect contact lenses and introduction of tap water rinsing of storage cases were associated with increased risk of Acanthamoeba infection. Penetrating keratoplasty is an effective treatment for medically unresponsive acanthamoeba keratitis. Confocal microscopy is the most effective and a fast diagnostic tool because it ensures the detection of acanthamebic cysts and trophozoids in corneal stroma