Monotherapy with PHMB 0.08% as "Switch Treatment" in Complex Cases of Acanthamoeba Keratitis: A Report of Two Cases.

IF 0.6 Q4 OPHTHALMOLOGY

Case Reports in Ophthalmology Pub Date : 2026-02-26 eCollection Date: 2026-01-01 DOI:10.1159/000551097

Eleftherios Chatzimichail, Isabel Stasik, Alexandra Steinemann, Frank Blaser, Zisis Gatzioufas

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引用次数: 0

Abstract

Introduction: The aim of the study was to describe the favorable clinical outcomes of 2 patients with acanthamoeba keratitis (AK) following penetrating keratoplasty (PK), successfully managed with polyhexamethylene biguanide (PHMB) 0.08% monotherapy.

Cases presentation: Both patients developed recurrent AK after PK, confirmed by microbiological testing and polymerase chain reaction (PCR). Standard dual therapy with PHMB 0.02% and propamidine isethionate 0.1% was either ineffective or poorly tolerated due to ocular surface toxicity. Transition to PHMB 0.08% monotherapy resulted in marked clinical improvement, resolution of keratitis, and substantial visual recovery. At follow-up examination 9 months postoperatively for case 1 and 12 months postoperatively for case 2, both patients demonstrated clear corneal grafts with no signs of AK recurrence.

Conclusion: PHMB 0.08% as monotherapy proved effective in managing recurrent AK after keratoplasty, achieving favorable anatomical and visual outcomes without recurrence during our follow-up period. These findings suggest that PHMB 0.08% monotherapy may serve as a viable alternative to conventional dual therapy, particularly in cases complicated by treatment intolerance or treatment failure. Further studies with larger cohorts and extended follow-up are warranted.

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0.08% PHMB单药治疗复杂棘阿米巴角膜炎2例报告

前言：本研究的目的是描述2例棘阿米巴角膜炎（AK）患者在穿透性角膜移植术（PK）后，经0.08%聚六亚甲基双胍（PHMB）单药治疗成功的临床结果。病例描述：两例患者均在PK后出现复发性AK，经微生物学检测和聚合酶链反应（PCR）证实。0.02% PHMB和0.1%异硫酸丙脒的标准双重治疗无效或由于眼表毒性而耐受性差。过渡到0.08%的PHMB单药治疗导致了明显的临床改善，角膜炎的消退和明显的视力恢复。在病例1术后9个月和病例2术后12个月的随访检查中，两例患者均显示角膜移植物清晰，无AK复发迹象。结论：0.08% PHMB单药治疗角膜移植术后复发性AK有效，随访期间无复发，解剖和视觉效果良好。这些发现表明，单药治疗可以作为传统双重治疗的可行替代方案，特别是在治疗不耐受或治疗失败的病例中。进一步的研究需要更大的队列和更长时间的随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Ophthalmology OPHTHALMOLOGY-

CiteScore

0.90

自引率

0.00%

发文量

129

审稿时长

12 weeks

期刊介绍： This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.