Original articleRiboflavin and Ultraviolet Light A Therapy as an Adjuvant Treatment for Medically Refractive Acanthamoeba Keratitis: Report of 3 Cases
Section snippets
Materials and Methods
The institutional review board of The Johns Hopkins University, Baltimore, Maryland, granted individual emergency therapeutic use approval for the treatment to be conducted on patients 1 and 2 of this series. Similar approval was obtained for patient 3 from the institutional review board of Instituto de Cirugía Ocular in San Jose, Costa Rica. Because this is a non-approved treatment of microbial keratitis in the United States, the US Food and Drug Administration authorized the emergent use of
Results
The clinical resolution of AK in these series was determined by improvement of symptoms, decreased ulcer size, reduction in signs of infection, and histopathology. Notably, all patients reported considerable pain within the first 48 hours after the application of the UVA/B2 treatment. However, this was followed by a dramatic decrease in pain and photophobia after 3 days of the UVA and B2 treatment, with no significant exacerbations of symptoms. The ulcers in all patients were visibly decreasing
Discussion
The patients presented in this report were of different ages and races, and from different geographic locations. They used different brands of contact lenses and lens care products. The only commonality between them illustrates a salient point about AK: Improper contact lens use and hygiene remain the most important risk factors for developing the infection.8 Patient 1 reported extended and periodic overnight wear of his contact lenses before his symptom onset.9 Patients 2 and 3 reported
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Manuscript no. 2010-96.
Financial Disclosure(s): The author(s) have made the following disclosure(s): Dr. Behrens is a patent owner for a wearable device that uses this photochemical therapy to treat infectious keratitis. The authors have no financial interests in the products described in this manuscript.
Funding: National Institutes of Health Small Business Innovation Research Grant R44EY015955-02S1; Research to Prevent Blindness (New York, NY); Fight for Sight (New York, NY).