Acanthamoeba keratitis associated with disposable hydrogel contact lenses disinfected daily with a chlorine-based care system

Abstract

Three patients developed acanthamoeba keratitis which was associated with the use of Acuvue disposable soft contact lenses between March 1991 and January 1992. All three patients removed their lenses each night, placed them in Softab disinfecting solution and discarded them every 2 weeks. Acanthamoeba polyphaga was cultured from the contact lens cases of two patients and from a corneal scrape of the third patient. All three patients were treated with intensive neomycin and propamidine isethionate. The keratitis resolved in two patients, but the third responded slowly to this therapy and the treatment was supplemented with topical polyhexamethylene biguanide; this patient is improving gradually, but is still under review. As is the case with all soft contact lenses worn on a daily basis, disposable lenses require a rigorous lens maintenance regime which should include rubbing and rinsing, preferably with a surfactant cleaner, and the use of an effective disinfecting solution.