Comparion of Polyhexamethylene Biguanide and Chlorhexidine a Monotherapy Agent in the Treatment of Acanthamoeba Keratiti Original Reearch Article

Purpoe To compare the therapeutic outcome of polyhexamethylene biguanide (PHMB) and chlorhexidine for Acanthamoeba keratiti. Deign Propective, double-maked, randomized comparative tudy. Method Fifty-ix eye of 55 patient with Acanthamoeba keratiti were randomized to receiving PHMB 0.02% or chlorhexidine 0.02%. Diagnoi wa made baed on poitive culture reult (cornea or contact len cae) or on clinical ground. The primary outcome meaure wa treatment failure defined a failure to induce a favorable clinical repone within two week. econdary outcome were: 1) recovery of viual acuity (VA), 2) the degree of corneal carring pottreatment, or 3) the need for penetrating keratoplaty. Reult Fifty-one eye completed the tudy. Twenty-three eye received PHMB and 28 received chlorhexidine. Ninety-eight percent were contact len wearer. Eighteen (78%) PHMB patient were treatment uccee compared with 24 (85.7%) chlorhexidine patient (P = .71). Diagnoi wa confirmed by poitive corneal culture reult in 26 cae (51%). Diagnoi wa made within 28 day in 29 cae (56.9%), between one and two month in 13 cae (25.5%), and after more than two month in eight cae (15.7%). Improvement in VA wa een in 13 eye (56.5%) receiving PHMB v 20 eye (71.4%) receiving chlorhexidine. Mild one-quadrant corneal carring wa een in 43.5% of eye receiving PHMB and 71.4% of eye receiving chlorhexidine, wherea moderate corneal carring in two or three quadrant wa een in 21.7% of eye receiving PHMB and in 10.7% of eye receiving chlorhexidine. Five eye worened while receiving PHMB v four eye worening while receiving chlorhexidine. Penetrating keratoplaty wa required in three eye from PHMB group and in two eye from chlorhexidine group. Concluion Outcome were imilar when uing PHMB and chlorhexidine a monotherapy agent in treating Acanthamoeba keratiti.