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Wydanie 4/2017
str. 126 - 128

Zapalenie rogówki wywołane przez szczepy pełzaków z rodzaju Acanthamoeba – leczenie zachowawcze czy wczesna keratoplastyka? Opis przypadku

Acanthamoeba Keratitis – Topical Treatment of Early Keratoplasty? Case Report

Mateusz Winiarczyk ¹ , Ewa Rakowska ¹ , Beata Rymgayłło-Jankowska ² , Edward Hadaś ³ , Jerzy Mackiewicz ¹

¹ Klinika Chirurgii Siatkówki i Ciała Szklistego Uniwersytetu Medycznego w Lublinie
Kierownik: dr hab. n. med. Jerzy Mackiewicz
² Klinika Mikrochirurgii Jaskry Uniwersytetu Medycznego w Lublinie
Kierownik: prof. dr hab. n. med. Tomasz Żarnowski
³ Katedra i Zakład Biologii i Parazytologii Lekarskiej Uniwersytetu Medycznego w Poznaniu
Kierownik: prof. dr hab. Anna Majewska

Summary: Purpose: Acanthamoeba keratitis is a potentially blindening condition caused by Acanthamoeba species. Incorrect diagnosis or mistreatment may lead to serious complications, including eyeball enucleation. In recent years rapid rise of patients suffering from this infection has occurred. Probably it is due to dramatic increase in number of soft contact lens wearers. Simultaneously, there are currently no official treatment or diagnosis protocols, and topical medications show insufficient efficacy. The purpose of this paper is to present a case report of a young patient with Acanthamoeba keratitis treated with keratoplasty following the failure of the topical treatment. This is due to growing evidence of surgical approach effectiveness.
Material and Methods: Retrospective case report with recent publication analysis.
Results: In the patient described total ineffectiveness of topical treatment was observed. With the penetrating keratoplasty the keratitis was managed, with total amoebic changes withdrawal.
Conclusions: In selected cases of local Acanthamoeba keratitis where lack of topical treatment efficacy is observed, early keratoplasty should be considered. With development in surgical techniques like deep anterior lamellar keratoplasty, it should no longer be a last therapeutical resort. Deferring surgery for too long may result in eventual enucleation of the eyeball, and does expose patient for unnecessary suffering.

Słowa kluczowe: Acanthamoeba, zapalenie rogówki, keratoplastyka, leczenie.

Keywords: Acanthamoeba, keratitis, keratoplasty, treatment.

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