Acanthamoeba Keratitis: What is the Best Time for Keratoplasty in Patients with Resistance to Conservative Therapy?

Acanthamoebic keratitis (AK) is a sight-threatening infectious keratitis caused by Acanthamoeba. Timely and appropriate conservative treatment of AK can lead to a cure of the keratitis with good visual acuity, without the need for keratoplasty in the further course of the disease. In treatment-resistant cases, keratoplasty after intensive anti-amoebic therapy (AAT), so-called "low-load keratoplasty", appears to offer a better overall prognosis and earlier visual and psychological rehabilitation than actively delayed keratoplasty (optical/therapeutic). Further studies directly comparing early and delayed keratoplasty are needed to even better determine the optimal timing of corneal transplantation in AK.