Investigate The Treatment And Prognosis Of 13 Cases Of Acanthamoeba Keratitis

Objective:To investigate the clinical features,treatment and prognosis of Acanthamoeba Keratitis.Methods:The clinical manifestations,auxiliary examination,treatment and results of patients with Acanthamoeba Keratitis from June 2014 to June 2017 were reviewed and analyzed.Main evaluation indexes:eye retention,recurrent infection,and best corrected vision.Results:A total of 13 patients(13 eyes)were collected,including 7 males and 6 females,aged 12-75 years(mean 46.8 years).Among them,1 case had contact lens wearing history,1 case had poultry contact history,1 case had sewage contact history,2 cases had external injury history,and the rest had no special history.The main clinical manifestations were ring infiltration(8 cases)and diffuse subcutaneous infiltration(4 cases).In the auxiliary examination,12 patients with corneal confocal microscopy found the structure of circular double-layer cyst,2 cases were positive in pathological section and 1 case was positive in pathogen culture.Only 1 case of drug therapy to achieve clinical cure and the remaining patients underwent surgical treatment(1 case of enucleation of ocular contents,1 case of conjunctival flap transplantation,2 cases of lamellar keratoplasty,7 cases of penetrating keratoplasty).Follow-up for 1-20 months(mean 9 months)showed that 11 patients(85%)retained eyeball after treatment,2 patients with recurrent infection accounted for 15.3%of the total cases,and 6 patients had the best corrected visual acuity ?0.05,of which 9 patients(69%)improved the best corrected visual acuity.Of the 7 cases with lesion depth?1/2 CT(corneal thickness),5 cases with the best corrected visual acuity>0.05 were followed up,accounting for 71.4%of the cases with lesion depth:<1/2CT.Of the 6 cases with corneal thickness>1/2,only 1 case with the best corrected visual acuity ?0.05 was followed up,accounting for 16.7%of the cases with corneal thickness>1/2.Conclusion:Early diagnosis and treatment of Acanthamoeba Keratitis is the key to a better prognosis.When there was no obvious improvement in drug conservative treatment and the depth of infiltration was more than 1/3 of the corneal thickness,surgical treatment could achieve a better prognosis.