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Acanthamoeba infection after radial keratotomy
R F Friedman1, T C Wolf, J Chodosh
1Department of Ophthalmology, Dean A. McGee Eye Institute, USA.
American Journal of Ophthalmology
|March 1, 1997
Summary
Acanthamoeba keratitis can occur after refractive surgery. Early diagnosis and treatment with anti-amebic therapy are crucial for recovery.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Refractive surgical procedures like radial and astigmatic keratotomy aim to correct vision.
- Complications, though rare, can include infectious keratitis.
- Delayed-onset infections pose diagnostic challenges.
Observation:
- A 29-year-old male presented with ulcerative keratitis in his right eye six weeks post-keratotomy.
- Initial bacterial and fungal cultures were negative.
- Corneal culture on non-nutrient agar revealed Acanthamoeba species.
Findings:
- Acanthamoeba organisms were identified as the causative agent of keratitis.
- The patient showed clinical improvement following topical anti-amebic treatment.
- Negative initial cultures highlight the importance of considering atypical pathogens.
Implications:
- Incisional keratotomy procedures may increase susceptibility to delayed infectious keratitis.
- Acanthamoeba should be considered in cases of refractory ulcerative keratitis post-keratotomy.
- Prompt culturing for Acanthamoeba is essential for appropriate management and visual preservation.