Chlorhexidine 0.02% or polyhexamethylene biguanide 0.02% as the main treatment for Acanthamoeba keratitis.
Chlorhexidine-treated eyes reached medical cure faster than those treated with polyhexamethylene biguanide.
Chlorhexidine 0.02% or polyhexamethylene biguanide 0.02% as the main treatment for Acanthamoeba keratitis.
To report medical cure and treatment failure rates of Acanthamoeba keratitis (acanthamoeba keratitis) with respect to type of treatment, disease stage and prognostic factors.
Received standardized treatment with either polyhexamethylene biguanide (polyhexamethylene biguanide) 0.02% (n = 27) or chlorhexidine 0.02% (n = 18) both in combination with propamidine 0.1%.
chlorhexidine cleared infection faster than polyhexamethylene biguanide, though diagnosis was also quicker in that group
All 29 patients (64%) presenting with stage 1 or 2 disease achieved medical resolution of the infection, irrespective of the treatment regimen.
Sixteen patients (36%) presented with stage 3 disease.
Twelve of these patients underwent therapeutic keratoplasty and were considered treatment failures.
All 12 cases of treatment failure occurred in patients who had received corticosteroid treatment prior to diagnosis and were significantly older than patients achieving medical cure.
Polyhexamethylene biguanide 0.02% and chlorhexidine 0.02% in combination with propamidine 0.1% demonstrated comparable clinical outcomes in the treatment of acanthamoeba keratitis, although the average treatment duration was shorter in chlorhexidine-treated eyes.
Steroid use before diagnosis and older patient age are significantly associated with higher risk of treatment failure.