Acanthamoeba keratitis related to orthokeratology

Abstract

To report four cases of Acanthamoeba keratitis related to the overnight wearing of orthokeratology lenses. Four patients had histories of overnight wearing of orthokeratology lenses when they presented with corneal ulcers. They had used a contact lens care system irregularly with tap water. The organism isolated by corneal scraping was Acanthamoeba. The patients were treated with polyhexamethylene biguanide (PHMB) and chlorhexidine, resulting in a resolution of ocular inflammation. The risk of Acanthamoeba keratitis as a potential complication of overnight orthokeratology should be considered, especially in patients with over one-year duration of contact lens wearing. Careful contact lens management is needed and tap-water rinsing should be eliminated from the lens care regimen.