Phenylephrine, tropicamide, fluorescein–proparacaine eyedrops, and GAT did not significantly affect predicted postoperative refraction as measured by the Lenstar optical biometer.
Purpose
To describe a case of recalcitrant Acanthamoeba Keratitis (AK) complicated by medical non-compliance and medication intolerance that was successfully treated with photoactivated chromophore for infectious keratitis corneal collagen cross-linking (PACK-CXL).
Observations
A 31-year-old male presented with right eye pain and redness in the setting of fresh water exposure and scleral contact lens wear. He had lack of a response to treatment with antiviral therapy for 3 months by an outside provider. Cultures were found to be positive for
Acanthamoeba
and the patient was treated with an extended course of various anti-amoebic therapies with poor compliance due to pain and toxicity. He was eventually treated with intrastromal voriconazole and Miltefosine without improvement and eventually had PACK-CXL with resolution of his infection and pain.
Conclusion
PACK-CXL was associated with a dramatic improvement in a case of recalcitrant
Acanthamoeba
keratitis unresponsive to both traditional and novel therapies and may be a viable alternative or adjunctive therapy for
Acanthamoeba
keratitis.
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