Posters

Effect of a topical solution of chlorhexidine and vitamin E TPGS in the treatment of Acanthamoeba Keratitis

Poster Details

First Author: C.Caruso ITALY

Co Author(s):    C. Caruso   L. Pacente   M. Troisi   S. Bartollino   C. Costagliola        

Abstract Details

Purpose:

To test the effectiveness and safety of a topical solution of chlorhexidine (CHX) and D-alpha-tocopherol poly(ethylene glycol) 1000 succinate (VE-TPGS) as monotherapy in the treatment of Acanthamoeba keratitis (AK)

Setting:

Pellegrini Hospital ASL NA 1. Institutional Review Board (IRB)/Ethics Committee approval was obtained (authorization n. 1269).

Methods:

Twenty-nine patients with AK were recruited. As baseline clinical examination BCVA and confocal microscopy were measured, along with a questionnaire filled by the patients. The treatment with CHX 0.02% and VE-TPGS 0,5% Was administered hourly in the first 24 hours, once an hour during the day for the next four days, and twice during daytime for the remaining 4 weeks. Other anti-acanthamoeba agents (polyhexamethylene biguanide and diamidine) were added to induce a better clinical response. Scleritis, uveitis, ocular pain and corneal stromal infiltration were treated with topical corticosteroids, started at least 2 weeks after treatment with chlorhexidine

Results:

Mean treatment time was 90.8 ± 22.9 days. mean BCVA was 0.79 (≥0.80 in 22 eyes). Twenty-six patients (89.6%) received topical corticosteroids with a mean duration of 65.81 ± 45.1 days. Propamidine was added to chlorhexidine/VE- TPGS in three patients (10,34%), whereas PHMB and propamidine only in one (3,44%). Complications included persistent epithelial defects (19.4%), punctate epithelial defects (29%), hypopyon (9.7%), and a corneal scar (25.8%)

Conclusions:

Topical solution based on chlorhexidine and vitamin E TPGS seems to be a safe and effective combination for the treatment of AK. The use of corticosteroids as adjunctive therapy depends on clinical condition

Financial Disclosure:

None