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Treatment of Acanthamoeba Keratitis by Corneal Cross-linking

Berra, Martín MD; Galperín, Gustavo MD; Boscaro, Gabriela MS; Zarate, Jorge MD, PhD; Tau, Julia MS; Chiaradia, Pablo MD, PhD; Berra, Alejandro PhD

doi: 10.1097/ICO.0b013e31825cea99
Basic Investigation

Purpose: To evaluate the efficacy of corneal cross-linking (CXL; riboflavin/ultraviolet A) as a simple therapy for Acanthamoeba keratitis.

Methods: Twenty rabbits were systemically anesthetized and the stroma of their right corneas was inoculated with a suspension of Acanthamoeba. Rabbits were divided into 2 groups: one group was treated with corneal CXL 3 days after infection and the other did not receive any treatment (control). All eyes in both groups were examined before (days 0 and 3) and after (day 7) CXL treatment. On day 7, the eyes were enucleated; 18 corneal buttons (9 of each group) were sent for microbiological examination and 2 (1 of each group) for histopathologic examination.

Results: All animals developed Acanthamoeba keratitis. There was no statistically significant difference between groups before treatment (day 0, P = 1, and day 3, P = 0.684). The treated corneas had a higher score (3.48 ± 0.30) at the time of enucleation compared with control corneas (2.60 ± 0.26). This difference was statistically significant (P = 0.008). Microbiological analysis revealed that the treated corneas had a higher protozoal count (2.86 ± 0.09) compared with the control corneas (2.18 ± 0.07); this difference was statistically significant (P = 0.001).

Conclusions: Treatment of Acanthamoeba keratitis by corneal CXL (riboflavin/ultraviolet A) did not prove effective in decreasing the intensity and severity of Acanthamoeba keratitis.

*Laboratorio de Investigaciones Oculares, Departamento de Patología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina

Hospital Pedro Lagleyze, Buenos Aires, Argentina

BioFundus, Buenos Aires, Argentina

§Servicio de Oftalmología, Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina.

Reprints: Martín Berra, Laboratorio de Investigaciones Oculares, Departamento de Patología, Facultad de Medicina, Universidad de Buenos Aires, José E. Uriburu 950, entrepiso, 1114 Buenos Aires, Argentina (e-mail:

The authors state that they have no financial or conflicts of interest to disclose.

Received January 23, 2012

Accepted April 29, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.