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Updated: May 26, 2026

Quantification of Acanthamoeba spp. Motility
Published on: September 20, 2024
Double-biguanide therapy for resistant acanthamoeba keratitis
Giulio Ferrari1, Stanislav Matuska, Paolo Rama
1Bietti Eye Foundation, Rome, Italy.
Aims:
To report the clinical and diagnostic findings of a patient with Acanthamoeba keratitis resistant to both polyhexamethylene biguanide (PHMB)-hexamidine and chlorhexidine-hexamidine treatment.
Methods:
Slit-lamp biomicroscopy, corneal cell scraping and histopathology were performed on a 39-year-old woman presenting with corneal ulcer in her left eye.
Results:
The patient was successfully treated with PHMB-chlorhexidine association therapy. Subsequent perforating keratoplasty remained clear at the last follow-up visit after 7 months and increased visual acuity to 20/20 with correction.
Conclusions:
This case emphasizes the proteiform aspects of Acanthamoeba drug resistance, and suggests that PHMB-chlorhexidine association might represent an additional option for cases resistant to standard therapy.
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