Acanthamoeba keratitis with live isolates treated with cryosurgery and fluconazole

PURPOSE: To report live, active trophozoites in an eye with Acanthamoeba ke ratitis that resembled Acanthamoeba polyphagia in the anterior chamber flui d obtained by transcorneal tap. METHOD: After prediagnostic therapy had failed, we performed cryosurgery to break the corneal cell walls and treated the patient. with oral fluconazol e. RESULTS: The condition resolved after 8 weeks of oral fluconazole therapy. Residual leukoma was treated by corneal graft. CONCLUSION: Live, motile Acanthamoeba can be isolated from an anterior cham ber tap; combination therapy with oral fluconazole after corneal cryosurger y may be effective. (Am J Ophthalmol 1999;127:718-720, (C) 1999 by Elsevier Science Inc. All rights reserved.).