Are cataract and iris atrophy toxic complications of medical treatment of acanthamoeba keratitis?

PURPOSE: Two cases of acanthamoeba keratitis with almost identical clinical courses developed mature cataract and iris atrophy after prolonged treatment with chlorhexidine 0.02% and propamidine isethionate 0.1%. It is suggested that these complications were caused by the chemicals, rather than resulting from the amoebae-induced inflammation. METHODS: Penetrating keratoplasty was performed in both cases when perforation from peripheral ulceration was threatening. RESULTS AND CONCLUSIONS: The immediate results were good. From these two cases it seems possible that there is a maximum level of intensity of the medical treatment and also that surgery should be considered at an earlier stage, before intraocular complications develop.