Acanthamoeba keratitis in patients wearing scleral contact lenses

Acanthamoeba keratitis in patients wearing scleral contact lenses

Author Sticca, Matheus Porto Autor UNIFESP Google Scholar
Carrijo-Carvalho, Linda C. Autor UNIFESP Google Scholar
Silva, Isa M. B. Autor UNIFESP Google Scholar
Vieira, Luiz A. Autor UNIFESP Google Scholar
Souza, Luciene B. Autor UNIFESP Google Scholar
Belfort Junior, Rubens Autor UNIFESP Google Scholar
Carvalho, Fabio Ramos S. Autor UNIFESP Google Scholar
Freitas, Denise Autor UNIFESP Google Scholar
Abstract Purpose: To report a series of cases of Acanthamoeba keratitis (AK) in scleral lens wearers with keratoconus to determine whether this type of contact lens presents a greater risk for development of infection. Methods: This study reports three patients who wore scleral contact lenses to correct keratoconus and developed AK. The diagnoses of AK were established based on cultures of the cornea, scleral contact lenses, and contact lens paraphernalia. This study investigated the risk factors for infections. Results: The possible risks for AK in scleral contact lens wearers are hypoxic changes in the corneal epithelium because of the large diameter and minimal tear exchange, use of large amounts of saline solution necessary for scleral lens fitting, storing the scleral lens overnight in saline solution rather than contact lens multipurpose solutions, not rubbing the contact lens during cleaning, and the space between the cornea and the back surface of the scleral lens that might serve as a fluid reservoir and environment for Acanthamoeba multiplication. Two patients responded well to medical treatment of AK

one is still being treated. Conclusions: The recommendations for use and care of scleral contact lenses should be emphasized, especially regarding use of sterile saline (preferably single use), attention to rubbing the lens during cleaning, cleaning of the plunger, and overnight storage in fresh contact lens multipurpose solutions without topping off the lens solution in the case.
Keywords Acanthamoeba keratitis
Scleral lens
Care systems
Corneal infection
Contact lens
Language English
Date 2018
Published in Contact Lens & Anterior Eye. Amsterdam, v. 41, n. 3, p. 307-310, 2018.
ISSN 1367-0484 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Bv
Extent 307-310
Origin http://dx.doi.org/10.1016/j.clae.2017.12.004
Access rights Closed access
Type Article
Web of Science ID WOS:000433290100012
URI http://repositorio.unifesp.br/handle/11600/45987

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