[Acanthamoeba keratitis, a possible dibromo propamidine isethionate resistance]. / Queratitis por acantamoeba, posible resistencia al dibromo propamidin isetionato.

PURPOSE/METHOD: To point out that acanthamoeba keratitis can show therapeutical resistance to dibrome propamidine isethionate (Brolene). We have a late diagnosis case of corneal melting on a bilateral acanthamoeba keratitis. RESULTS/CONCLUSION: We performed corneal graft in one eye and found histopathological evidence of acanthamoeba. There was relapse in the graft in spite of Brolene treatment and good results when we changed to polyhidroxy methylbigunide (PHMB). In case of therapeutical Brolene resistance, PHMB can be an adequate alternative (Arch Soc Esp Oftalmol 2002; 77: 279-282).

AMO array multifocal versus monofocal intraocular lenses: long-term follow-up.

PURPOSE: To assess prospectively the visual outcomes of multifocal and monofocal intraocular lens (IOL) implantation in selected patients with a minimum follow-up of 18 months. SETTING: Department of Ophthalmology, National Health Service (INSALUD). Puerta de Hierro University Clinic, Madrid, Spain. METHODS: This prospective study comprised two groups of 50 eyes each: one with AMO Array multifocal IOLs and the other with monofocal IOLs. Main outcome measures were Snellen and Regan 96% distance visual acuities; Jaeger and decimal near acuities; Regan contrast sensitivity test at 96, 50, 25, and 11%; brightness acuity test (BAT) on distance acuity at Regan 96%; depth of focus measured with the Regan 96% distance test; defocusing from +3s to -4s; subjective evaluation of optical side effects. RESULTS: The differences between groups in mean distance vision and BAT results were not statistically significant Contrast sensitivity results at 96 and 50% were similar, but there were significant differences of 0.94 and 1.14 lines on the 25 and 11% charts, respectively (P < .01). Near vision without addition in the multifocal group was significantly better and depth of focus significantly wider than in the monofocal group (P < .001). CONCLUSION: With appropriate patient selection, the AMO Array IOL provided distance acuity and contrast sensitivity similar to that of the monofocal IOLs and excellent intermediate vision. Near vision, without spectacles, with the multifocal lens was functionally acceptable although short of refractive power for best acuity results.