Acanthamoeba keratitis with live isolates treated with cryosurgery and fluconazole.

PURPOSE: To report live, active trophozoites in an eye with Acanthamoeba keratitis that resembled Acanthamoeba polyphagia in the anterior chamber fluid obtained by transcorneal tap.

METHOD: After prediagnostic therapy had failed, we performed cryosurgery to break the corneal cell walls and treated the patient with oral fluconazole.

RESULTS

The condition resolved after 8 weeks of oral fluconazole therapy. Residual leukoma was treated by corneal graft.

CONCLUSION

Live, motile Acanthamoeba can be isolated from an anterior chamber tap; combination therapy with oral fluconazole after corneal cryosurgery may be effective.