Role of Topical Chlorhexidine in Treatment of Acanthamoeba Keratitis
K. Mohan Raj1, Bhushan Uplanchiwar2, and K. Bhargavi21Department of Ophthalmology, Sree Balaji Medical College and Hospital, Bharath University, CLC Works Road, Chrompet, Chennai, Tamil nadu- 600044.
2Sree Balaji Medical College and Hospital, Bharath University, CLC Works Road, Chrompet, Chennai, Tamil nadu- 600044.
Abstract: A prospective non randomized trial of 12 patients done in Sree Balaji Medical College with a study period of 6 months from January 2014-June 2014.Patients who came to OPD with diffuse stromal infiltration and corneal ring infiltrate with smear positive for Acanthamoeba were selected for the study.. All patient had undergone workup under which visual acuity and slit lamp examination was done. The patients were divided into 3 groups on the basis of vision, corneal infiltrate location and the time of presentation. All patient were treated with topical chlorhexidine 0.03% along with cycloplegics. The minimum followup period was for 6 months.The outcome was measured by regression of symptoms and signs like reduction in corneal infiltration and improvement in vision.Vision improvement was defined as improvement in 2 lines of logmar. 2 patient were school going, 4 patients were doing office work, 6 were farmers. 4 patients had history of washing eyes with contaminated water, while 8 patients had history of injury either with vegetative matter or dust particle Group 1 patient responded to topical chlorhexidine within 8-10 days but the BCVA remained same at the end of treatment of mean bcva 1.3 , group 2 responded within 1 week with fast healing of ulcer. There was improvement in visual acuity of mean bcva 0.64 , group 3 responded well to treatment with improvement within 1 week and improvement in visual acuity of mean bcva 0.2 During treatment with topical chlorhexidine 2 patients of group 1 developed redness after 2 weeks of treatment. 2 patients of group1 were advised optical therapeutic keratoplasty since there was nil improvement in vision. Topical chlorhexidine therapy when used for treatment of Acanthamoeba keratitis lead to subjective improvement of symptoms as well as clinical signs. It is easily available , less side effect and easily available in the market. Our study thus concludes that it is a good alternative for medical treatment.
Keywords: Acanthamoeba keratitis; topical chlorhexidine; stromal infiltration; ring infiltrate Back to TOC