Voriconazole Shows Promise in Treating Acanthamoeba Keratitis

I am now trying a combined Voriconazole, (chlorhexidine, PHMB Q2H) therapy that reportedly works on some resistant cases. Even though both are biguanides, there apparently is sometimes a synergistic effect. It seemed to worsen not long after stopping the hexamidine as it was thought all three would be too toxic. Any thoughts on using hexamidine instead of PHMB for every third dose or so? Any thoughts or research on increasing the Voriconazole from 200 mg BID to 300 mg BID?

I have read UV therapy has a very high success rate. Hoping to talk to my doctors about it tomorrow. Any thoughts on this?

I have resistant Acanthamoeba brought on by abrading my cornea then rinsing repeatedly with tap water. Acanthamoeba diagnosis was a very short ten days from the date of the scratch. Started on PHMB hourly. In three weeks, initial bloom was gone, but a second developed, and hourly hexamidine was started, both at Q2H for night time. Central cornea epithelium mostly dissolved, and a fairly large epithelium defect developed close to the perimeter. PHMB was reduced to Q2H and Hexamidine to Q4H, then further reduced to Q6H as it is supposedly more toxic to the eye.. Another bloom occurred, and Voriconazole was started, and used concurrently with PHMB and Hexamidine. Three weeks after starting Voriconazole, another outbreak occurred, this time further towards the periphery.

We will soon be considering a corneal transplant despite early detection and tri-therapy. NOT much fun!!