USE OF PHMB 0.08% EYE DROPS FOR THE TREATMENT OF ACANTHAMOEBA KERATITIS: A CASE REPORT

Acanthamoeba keratitis (AK) is a rare but very serious cause of keratitis. It is usually underdiagnosed in early stages, so it is important to suspect it, especially in contact lens wearers. It usually requires prolonged medical treatment, as well as surgery. Its management is difficult due to its severity, diagnostic delay and lack of standard treatment. Based on a real case, we intend to report the effectiveness of polyhexamethylene biguanide (PHMB) 0.08% monotherapy in AK.

Department of Ophthalmology, Mútua Terrassa University Hospital, Terrassa, Barcelona, Spain.

 We present a case of unilateral AK in a 41-year-old soft contact lens wearer. For his treatment a combination of chlorhexidine 0.02% and hexaminide was used, as well as lubricants, topical corneal re-epithelializers without preservatives and metalloproteinase inhibitors, in addition to oral analgesia. After 6 months, due to the lack of improvement, it was decided to start compassionate use treatment with PHMB 0.08% in monotherapy together with lubricants and topical re-epithelializers.

 Two months after initiating PHMB 0.08% as a monotherapy treatment for AK, resolution of the infection was achieved. Finally, a penetrating keratoplasty was performed to improve the patient's visual acuity.

Early diagnosis and treatment are key to the management of AK. It is important to consider the efficacy of polyhexadine (PHMB), whose use in monotherapy at 0.08% has been shown to be as or more effective than the usual treatments. Its approval as a treatment for AK is currently pending, making it the first and only medical therapy approved in Europe for this disease.