In rare cases, Acanthamoeba keratitis does not resolve with antiamoebic medical treatment alone and progresses toward corneal perforation. This critical presentation requires a specific combined management strategy.
When a patient with Acanthamoeba keratitis fails to respond to medical therapy and faces impending corneal perforation, standard antiamoebic regimens are insufficient on their own. A more interventional approach becomes necessary to preserve the eye.
In rare instances when a patient is unresponsive to medical therapy with impending perforation, combined penetrating keratoplasty and medical therapy may be employed.
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