Clinical SciencePractice Patterns and Opinions in the Treatment of Acanthamoeba KeratitisOldenburg, Catherine E MPH; Acharya, Nisha R MD, MS; Tu, Elmer Y MD; Zegans, Michael E MD; Mannis, Mark J MD; Gaynor, Bruce D MD; Whitcher, John P MD, MPH; Lietman, Thomas M MD; Keenan, Jeremy D MD, MPHAuthor Information From the *F.I. Proctor Foundation and †Department of Ophthalmology, University of California, San Francisco, San Francisco, CA; ‡Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL; §Department of Surgery, ¶Department of Microbiology and Immunology, Dartmouth Medical School, Hanover, NH; and ‖Department of Ophthalmology and Vision Science, University of California, Davis Eye Center, Sacramento, CA. Received for publication August 19, 2010; revision received December 22, 2010; accepted January 6, 2011. Supported by National Institutes of Health/National Eye Institute Grant Numbers K23EY017897 (N.R.A.), K12EX017269 (B.D.G.), and K23 EY019071 (J.D.K.) and by National Institutes of Health/National Center for Research Resources/Office of the Director Grant Number KL2 RR024130, which funds the University of California, San Francisco Clinical and Translational Science Institute (N.R.A. and J.D.K.). The authors state that they have no proprietary or conflicts of interest to disclose. Reprints: Dr Jeremy D. Keenan, Department of Ophthalmology and F.I. Proctor Foundation, 95 Kirkham St, Room 307, University of California, San Francisco, San Francisco, CA, 94143-0944 (e-mail: [email protected]). Cornea: December 2011 - Volume 30 - Issue 12 - p 1363-1368 doi: 10.1097/ICO.0b013e31820f7763 Buy Metrics Abstract Purpose: Management of acanthamoeba keratitis remains challenging for ophthalmologists. We conducted a survey of members of The Cornea Society to elicit expert opinions on the diagnosis and treatment of acanthamoeba keratitis. Methods: An online survey was sent to all subscribers of The Cornea Society via the kera-net listserv. Descriptive statistics were performed. Results: Eighty-two participants completed the online survey. Of the 82 respondents, 76.8% included the combination of clinical examination and culture in their diagnostic strategy and 43.9% used confocal microscopy. Most respondents (97.6%) had used combination therapy with multiple agents to treat acanthamoeba keratitis at some point in the past, whereas a smaller proportion (47.6%) had ever used monotherapy. Respondents most commonly chose polyhexamethylene biguanide as the ideal choice for monotherapy (51.4%), and dual therapy with a biguanide and diamidine as the ideal choice for combination therapy (37.5%). The majority of respondents (62.2%) reported using topical corticosteroids at least some of the time for acanthamoeba keratitis. Keratoplasty was an option considered by most respondents (75.6%), although most (85.5%) would only perform surgery after medical treatment failure. Conclusions: There was a wide range of current practice patterns for the diagnosis and treatment of acanthamoeba keratitis. The lack of sufficiently powered comparative effectiveness studies and clinical trials makes evidence-based decision-making for this disease difficult. Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.