Early Therapeutic Keratoplasty for Acanthamoeba Keratitis

Purpose: To describe the findings, recurrence rate and complications following therapeutic penetrating keratoplasty (PK) in eyes with Acanthamoeba keratitis (AK). Methods: A retrospective study comparing eyes that underwent surgery in the early stages of the disease versus eyes that had surgery delayed for more than five months of disease. Results: The study analyzed 23 eyes with similar demographic characteristics. Seventeen eyes (73.91%) underwent early surgical procedures within five months (Group 1), and 6 (26.08%) had the late PK after five months (Group 2). The mean clinical treatment time between the first symptoms and surgical procedure was 1.80 + 0.915 months in group 1 and 7.83 + 2.48 months in group 2 (p < 0.001). Patients in Group 1 achieved a final mean Best-corrected visual acuity (BSCVA) of logMar 0.61 + 1.07 versus 0.98 + 0.85 in Group 2 (p =0.416). Recurrence of the AK infection occurred in 11.8% (2/17) of the early PK group and in 50% (3/6) of the eyes that underwent a late therapeutic PK (p = 0.051). Cornea rejection was the most reported complication following PK, and it affected 35.3% (6/17) of the eyes in Group 1 versus 66.7% (4/6) of the eyes in Group 2 (p = 0.183). Secondary glaucoma affected 17.6% (3/17) of patients who have undergone early PK versus 66.7% (4/6) of the eyes where surgery was delayed (p = 0.025). Conclusions: Early therapeutic PK for Acanthamoeba keratitis might have beneficial results concerning the cure of infection, fewer complications, and better visual acuity recovery than a late one.