Rapidly progressive cataract and iris atrophy during treatment of Acanthamoeba keratitis.

PURPOSE: To identify characteristics associated with cataract occurring during the course of Acanthamoeba keratitis.

DESIGN

Retrospective observational case series.

PARTICIPANTS

Eighty-one laboratory-confirmed patients with Acanthamoeba keratitis.

METHODS

Review of clinical records.

MAIN OUTCOME MEASURES: Development of cataract during management of Acanthamoeba keratitis.

RESULTS

Rapidly progressive crystalline lens opacification occurred in 9 eyes within 4 to 15 weeks after diagnosis of Acanthamoeba keratitis. Three were associated with inflammatory complications, including anterior scleritis (2 eyes) and iridocyclitis (1 eye). Six others had the abrupt onset of a dense cataract, including 5 with iris atrophy, that occurred during the initial 6 months of therapy with chlorhexidine, a diamidine, and adjunctive corticosteroid. Extracapsular cataract extraction was performed with or after penetrating keratoplasty. Secondary glaucoma developed in 6 of 9 eyes subsequent to iris atrophy (4 eyes) or a cyclitic membrane (2 eyes), and 3 eyes underwent trabeculectomy.

CONCLUSIONS

Cataract may occur and progress during the management of Acanthamoeba keratitis in association with anterior segment inflammation, iris atrophy, and secondary glaucoma.