Rapidly Progressive Cataract and Iris Atrophy during Treatment of Acanthamoeba Keratitis
Presented at: American Society of Cataract and Refractive Surgery Annual Meeting, March 2006, San Francisco, California.
Received 29 January 2007; received in revised form 18 May 2007; accepted 22 May 2007.
Purpose
To identify characteristics associated with cataract occurring during the course of Acanthamoeba keratitis.
Design
Retrospective observational case series.
Participants
Eighty-one laboratory-confirmed patients with Acanthamoeba keratitis.
Methods
Review of clinical records.
Main Outcome Measures
Development of cataract during management of Acanthamoeba keratitis.
Results
Rapidly progressive crystalline lens opacification occurred in 9 eyes within 4 to 15 weeks after diagnosis of Acanthamoeba keratitis. Three were associated with inflammatory complications, including anterior scleritis (2 eyes) and iridocyclitis (1 eye). Six others had the abrupt onset of a dense cataract, including 5 with iris atrophy, that occurred during the initial 6 months of therapy with chlorhexidine, a diamidine, and adjunctive corticosteroid. Extracapsular cataract extraction was performed with or after penetrating keratoplasty. Secondary glaucoma developed in 6 of 9 eyes subsequent to iris atrophy (4 eyes) or a cyclitic membrane (2 eyes), and 3 eyes underwent trabeculectomy.
Conclusions
Cataract may occur and progress during the management of Acanthamoeba keratitis in association with anterior segment inflammation, iris atrophy, and secondary glaucoma.
Sid W. Richardson Ocular Microbiology Laboratory, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
Correspondence to Kirk R. Wilhelmus, MD, Cullen Eye Institute, 6565 Fannin Street, Houston, TX 77030.
Manuscript no. 2007-135.
Supported in part by the Sid W. Richardson Foundation, Fort Worth, Texas, and Research to Prevent Blindness, Inc., New York, New York.
The authors have no financial interest related to the article.
ABSTRACT