SMILE和FS-LASIK与LASIK矫正近视术后6mo的有效性和稳定性分析

目的：对比分析飞秒激光小切口角膜基质透镜取出术、飞秒激光制瓣准分子激光原位角膜磨镶术和准分子激光原位角膜磨镶术后6 mo的视力和屈光度,评价三种手术方式的有效性和稳定性。
　　方法：回顾性分析2014-04/06在我院行角膜屈光手术患者110例220眼术后6 mo的随访资料,其中飞秒激光小切口角膜基质透镜取出术( small incision lenticule extraction, SMILE)患者42例84眼,飞秒激光制瓣准分子激光原位角膜磨镶术( femtosecond laser in situ keratomileusis, FS-LASIK)37例74眼,准分子激光原位角膜磨镶术( laser in situ keratomileusis,LASIK)31例62眼。术前三组患者平均等效球镜度分别为-5.91±1.83、-5.89±1.96、-5.88±1.68D,术前三组患者最佳矫正视力( best corrected visual acuity,BCVA)、瞳孔直径差异及中央角膜厚度均无统计学差异(P>0.05)。对比分析三组患者术后1wk,1、3、6mo随访时裸眼视力( uncorrected visual acuity,UCVA)、最佳矫正视力( best corrected visual acuity,BCVA)、屈光度等。结果：(1)术后1wk 和1mo 所有患者均按时随访,术后3 mo时 SMILE 和 FS-LASIK 与 LASIK 组分别有5例10眼、5例10眼、4例8眼失访,术后6 mo随访SMILE和FS-LASIK与LASIK组分别有9例18眼、6例12眼、7例14眼失访。(2)术后1wk, SMILE 和 FS-LASIK 与 LASIK 组UCVA的差异具有统计学意义( t=4.098, P=0.000;t=2.493,P=0.004)。(3) LASIK组术后1wk与术后3、6mo的UCVA差异具有统计学意义( t=3.410, P=0.001;t=3.771,P=0.000),术后1 mo与术后6 mo的UCVA差异具有统计学意义(t=2.283,P=0.026)。(4)术后1wk,1、3、6 mo三组患者屈光度的差异均无统计学意义(χ2=0.119, P=0.942;χ2=1.504,P=0.471;χ2=0.949,P=0.622;χ2=0.277,P=0.871)。(5)术后1wk,SMILE组和FS-LASIK组与LASIK组裸眼视力≥5.0的眼数差异具有统计学意义(χ2=9.249, P=0.002<0.016;χ2=12.906, P=0.000<0.0016),而FS-LASIK组与LASIK组裸眼视力≥5.0的眼数差异无统计学意义(χ2=0.500,P=0.604)。(6)三组患者术后1wk和1、3、6mo的等效球镜度数在±0.50D范围内的眼数差异无统计学意义(χ2=0.809,P=0.697;χ2=1.176,P=0.634;χ2=0.871,P=0.736;χ2=0.683,P=0.770)。结论：在术后6 mo内SMILE和FS-LASIK与LASIK矫正近视均具备有效性和稳定性,但SMILE在术后1 wk的有效性优于FS-LASIK及LASIK,能够在术后更快速地改善裸眼视力。     

LASIK术前人工泪液干预对术后泪膜的影响

目的:观察术前人工泪液干预的飞秒激光制瓣LASIK术后泪膜的变化及干眼的原因分析.方法:收集2014-07/2015-07于我院行飞秒激光制瓣LASIK并随访6mo者434例859眼.根据术前是否滴用人工泪液分为二组,患者被随机分为对照组(组1)和试验组(组2),组1为术前未滴用人工泪液,205例408眼;组2为术前滴用人工泪液,229例451眼.观察术前、术后1wk,1、3、6mo的干眼症状评分、泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)、角膜荧光素染色(FL)评分的变化及相关因素.结果:干眼症状评分:两组术后1wk、1 mo差异有统计学意义(P＜0.05),术后3、6mo差异无统计学意义(P＞0.05).术后1wk、1 mo与术前差异均有统计学意义(P＜0.05),术后3、6mo与术前差异无统计学意义(P＞0.05).BUT:两组术后1wk,1、3mo差异有统计学意义(P＜0.05),术后6mo差异无统计学意义(P＞0.05).术后1wk,1、3mo与术前差异均有统计学意义(P＜0.05),术后6mo与术前差异无统计学意义.Schirmer I试验:两组术后1wk,1 mo差异有统计学意义(P＜0.05),术后3、6mo差异无统计学意义(P＞0.05).术后1wk、1 mo与术前差异有统计学意义(P＜0.05),术后3、6mo与术前差异无统计学意义(P＞0.05).FL评分:两组术后1wk,1、3mo差异有统计学意义(P＜0.05),术后6mo差异无统计学意义(P＞0.05).术后1wk,1 mo与术前差异有统计学意义(P＜0.05),术后3、6mo与术前差异无统计学意义(P＞0.05).结论:飞秒激光制瓣LASIK术后早期泪膜功能减退,但术前滴用人工泪液干预后泪膜功能恢复更快.     

SMILE和FS-LASIK术治疗高度近视的疗效及对角膜和泪膜稳定性的影响

目的：探讨飞秒激光小切口角膜基质透镜取出术(SMILE)和飞秒激光制瓣的准分子激光角膜原位磨镶术(FS-LASIK)矫正高度近视的临床效果和对角膜、泪膜稳定性的影响。

方法：选取2016-08/2017-02我院收治的高度近视患者120例240眼作为研究对象,按照手术方式分为SMILE组(67例134眼)和FS-LASIK组(53例106眼)。SMILE组患者行SMILE术治疗,FS-LASIK组患者行FS-LASIK术治疗,比较两组患者术后视力和屈光度情况,分析手术对角膜和泪膜稳定性的影响。

结果：术后1、3mo,两组患者UCVA、BCVA和屈光度比较,差异均无统计学意义(P>0.05)。术前、术后1mo,两组患者BUT和SⅠt比较,差异均无统计学意义(P>0.05); 术后3mo,两组患者BUT和SⅠt比较,差异均有统计学意义(P<0.001),且SMILE组明显优于FS-LASIK组。术前和术后 1、3mo,两组患者角膜最薄点高度和角膜后表面高度比较,差异均无统计学意义(P>0.05)。

结论：SMILE和FS-LASIK术治疗高度近视均安全有效,有很好的可预测性和稳定性,但SMILE术后泪膜稳定性优于FS-LASIK术,两种术式在角膜生物力学稳定性方面无明显差异。     

SMILE矫正超高度近视的临床研究

目的:观察飞秒激光角膜基质小切口透镜取出术(small incision lenticule extraction,SMILE)矫正超高度近视的临床疗效.方法:选取超高度近视患者64例 128眼,随机分为SMILE组与FS-LASIK组各32例 64 眼,分别给予VisuMax飞秒激光系统下SMILE治疗和飞秒激光制瓣的LASIK (femtosecond laser LASIK,FS-LASIK),观察术前,术后1d,1wk,1、3、6mo裸眼视力、最佳矫正视力、等效球镜,计算有效性指数及安全性指数等.结果:安全性指数:SMILE组与FS-LASIK组术后6mo时分别为1.10±0.10和1.08±0.12,两组相比差异无统计学意义(P>0.05).有效性指数:SMILE组与FS-LASIK组术后6mo时分别为1.08±0.12和1.06±0.14,两组相比差异无统计学意义(P>0.05).术后6mo时的等效球镜SMILE组为0.09±0.36D,FS-LASIK组为0.36±0.46D,两组患者等效球镜在±0.50D 者SMILE组有58眼(90.1%),FS-LASIK组有49 眼(76.6%);在±1.0D 者SMILE组有64 眼(100%), FS-LASIK组有60眼(93.8%).结论:采用SMILE 治疗超高度近视安全有效,与FS-LASIK相比SMILE术后视力和屈光度能更早稳定下来.     

FS-LASIK与SMILE术后干眼参数与角膜知觉的比较

比较飞秒激光制瓣准分子激光原位角膜磨镶术（FS-LASIK）与飞秒激光小切口角膜基质透镜取出术（SMILE）术后不同时间点干眼参数与角膜知觉的变化,探讨不同手术方式对泪膜及角膜知觉的影响并分析2项指标之间的相关性。方法：前瞻性非随机对照研究。行FS-LASIK患者24例（48眼）,行SMILE患者21例（41眼）。在术前及术后1、3个月采用Keratograph 5M眼表综合分析仪行泪河高度（TMH）、非入侵性泪膜破裂时间（NIBUT）[包括首次泪膜破裂时间（NIF-BUT）与平均泪膜破裂时间（NIAvg-BUT）]的检查,并进行中央角膜知觉检查。组内手术前后各观察指标的比较采用重复测量方差分析;组间一般资料及各观察指标的比较用独立样本t检验;角膜知觉与干眼参数的相关性采用 Spearman相关分析。结果：2组间术前各干眼参数与中央角膜知觉差异均无统计学意义。FS-LASIK 组与SMILE组TMH在术后1个月和3个月较术前均下降（F=21.213,P<0.001;F=14.648,P<0.001）, SMILE组术后2 个时间点的TMH高于FS-LASIK组（t=-5.549,P<0.001;t=-3.028,P=0.003）。 FS-LASIK组NIF-BUT术后1个月较术前下降（F=4.603,P=0.019）;而SMILE组NIF-BUT在术后2个时间点较术前值虽下降,但差异无统计学意义（F=0.599,P=0.516）;术后1个月SMILE组NIF-BUT优 于FS-LASIK组（t=-3.430,P=0.001）。FS-LASIK组NIAvg-BUT在术后1个月较术前下降（F=3.580, P=0.042）;SMILE组NIAvg-BUT术后2个时间点较术前虽下降,但差异均无统计学意义（F=0.274, P=0.761）;SMILE组NIAvg-BUT 2 个时间点均在术后优于FS-LASIK组（t=-2.395,P=0.019; t=-2.431,P=0.017）。FS-LASIK组中央角膜知觉术后各时间点较术前下降,术后3个月高于术后1个月（F=121.919,P<0.001）;SMILE组中央角膜知觉术后1个月较术前下降（F=54.032,P<0.001）;术后各时间点SMILE组均优于FS-LASIK组（t=-5.367,P<0.001;t=-3.242,P=0.002）。2组术后各时间点中央角膜知觉与干眼参数均呈正相关性（均P<0.05）。结论：FS-LASIK和SMILE组的干眼参数与中央角膜知觉均会出现不同程度的下降,患者行SMILE术后干眼参数与中央角膜知觉优于行FS-LASIK 者,且中央角膜知觉与干眼参数均呈正相关性。     

SMILE、飞秒激光制瓣LASIK及去瓣机械法LASIK术后干眼参数的比较

目的 比较SMILE、飞秒激光制瓣LASIK(FS-LAISK)以及机械法去瓣LASIK(Epi-LASIK)手术前后不同时间点干眼参数的变化情况,探讨不同手术方式对泪膜的影响.方法 前瞻性病例对照研究.行SMILE者(SMILE组)33例(66眼),行FS-LAISK者(FS-LAISK组)24例(48眼),行Epi-LASIK者(Epi-LASIK组)31例(61眼).分别在术前、术后1周、1个月、3个月、6个月采用眼前节OCT测量患者的泪河高度(TMH)、泪膜破裂时间(BUT)、基础泪液分泌量(SIT).不同组别一般资料及干眼参数的比较采用单因素方差分析,同一组内手术前后的比较采用重复测量方差分析.结果 SMILE组术后各时间点TMH与术前相比,差异均无统计学意义(F=1.225,P＞0.05);FS-LASIK组TMH在术后1个月内较术前降低,差异有统计学意义,并于术后3个月逐渐恢复(F=3.806,P＜0.05);Epi-LASIK组TMH在术后3个月内较术前下降,差异有统计学意义,直至术后6个月恢复术前水平(F=4.564,P＜0.05).术后各时间点,3组间TMH差异均有统计学意义(F=4.749、8.173、3.850、2.830,P＜0.05).SMILE组和FS-LASIK组BUT在术后3个月内,与术前相比差异有统计学意义,并在术后6个月恢复至术前水平(F=2.860、3.590,P＜0.05).Epi-LASIK组术后各时间点的BUT较术前降低,差异有统计学意义(F=12.800,P＜0.01).3组间BUT在术前、术后1周及术后1个月差异均无统计学意义(F=0.966、0.115、0.991,P＞0.05),而术后3、6个月,3组间BUT差异有统计学意义(F=4.448、6.634,P＜0.05).SMILE组和FS-LASIK组SIT在术后1周、1个月均较术前降低,且差异有统计学意义,并于术后3个月恢复至术前水平(F=14.160、13.323,P＜0.01);EPi-LASIK直至术后6个月才恢复至术前水平(F=10.085,P＜0.01).除术后3个月外(F=10.021,P＜0.01),术后其余时间点3组间SIT差异无统计学意义(F=0.005、2.210、1.054,P＞0.05).结论 3种屈光手术后早期均会出现不同程度的干眼参数改变.SMILE术后干眼参数最佳,恢复最快.     

飞秒激光与机械板层刀制瓣的LASIK术后干眼的临床对比研究

目的：应用Oculus干眼分析仪观察飞秒激光与机械板层刀制瓣的LASIK术后干眼情况。方法：收集2014-01/04在潍坊眼科医院行飞秒激光制瓣的准分子激光原位角膜磨镶术( FS-LASIK)及机械板层刀制瓣准分子激光原位角膜磨镶术( LASIK )的患者60例120眼,年龄27.46±6.65岁。其中LASIK组28例56眼, FS-LASIK组32例64眼。应用Oculus干眼分析仪观察患者术前、术后1 wk及术后1 mo时泪河高度、首次泪膜破裂时间、平均泪膜破裂时间随时间的变化。结果：Oculus 干眼分析仪检查术前泪河高度为0.25±0.10mm,首次泪膜破裂时间为6.70±3.86s,平均泪膜破裂时间为10.14±4.51 s。术后1 wk 泪河高度为0.19±0.04mm,首次泪膜破裂时间为4.87±1.71s,平均泪膜破裂时间为7.77±2.30s,两组患者术后1wk与术前相比差异有统计学意义(P<0.05)。术后1mo泪河高度为0.19±0.18mm,平均泪膜破裂时间为8.72±2.54s,首次泪膜破裂时间为5.02±2.30s,两组患者术后1mo与术前相比差异有统计学意义(P<0.05)。两组患者术后1mo与术后1 wk泪河高度及平均泪膜破裂时间差异均有统计学意义。术后1 mo首次泪膜破裂时间与术后1 wk相比差异无统计学意义。 FS-LASIK与LASIK组组间比较,差异无统计学意义(P>0.05)。结论：机械板层刀制瓣LASIK和FS-LASIK术后患者均有不同程度的干眼,泪液分泌量及泪膜的稳定性均有不同程度的下降,加用人工泪液干眼症状有所改善。 Oculus干眼分析仪非侵入性的反映泪液量及泪膜稳定性,有利于LASIK术后干眼的快速诊断及严重程度的判断。     

飞秒激光制瓣LASIK术后不同性别泪膜的变化与分析

目的：观察飞秒激光制瓣LASIK术后不同性别泪膜的变化。

方法：收集2013-08/09于我院行飞秒激光制瓣LASIK术并随访3mo的患者120例240眼,将其按性别分为两组,A组：男55例110眼,B组：女65例130眼,观察两组术前、术后1wk; 1,2,3mo患者的干眼症状评分、泪膜破裂时间(break-up tear time,BUT)、泪液分泌试验(Schirmer Ⅰ test,SⅠt)、角膜荧光素染色(corneal fluorescence stain,FL)评分的变化。

结果：主观干眼症状评分：两组术后1wk; 1,2mo差异有统计学意义(P=0.000,0.023, 0.030),术后3mo差异无统计学意义(P=0.283)。 BUT：两组术后1wk; 1,2,3mo差异有统计学意义(P=0.000,0.017, 0.026, 0.032)。 SⅠt：两组术后1wk; 1,2mo差异有统计学意义(P=0.012,0.024, 0.018),术后3mo差异无统计学意义(P=0.206)。 FL评分：两组术后1wk; 1,2,3mo差异有统计学意义(P=0.022,0.015, 0.036, 0.041)。

结论：飞秒激光制瓣LASIK术后泪膜功能的影响男性小于女性。     

飞秒激光小切口基质透镜取出术治疗近视及散光

目的:探讨飞秒激光小切口角膜基质透镜取出术治疗近视及散光的有效性、可预测性、稳定性和安全性.方法:前瞻性临床对照研究.近视及近视散光患者547例1 080眼,按患者选择的手术方式分为两组,小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)组285例560眼,飞秒激光辅助的准分子激光原位角膜磨镶术(femtosecond laser assisted laser in situ keratomileusis,FS-LASIK)组262例520眼.术后随访12mo,分别于术后第1d,1wk,1、6、12mo复查,检查裸眼及矫正视力、屈光度、裂隙灯及角膜地形图,并测量偏中心切削值.结果:术后第1d,1wk,1、6、12mo,SMILE组的裸眼视力(uncorrected visual acuity,UCVA,以LogMAR视力表示)分别为0.029±0.13、0.001±0.11、-0.019±0.11、-0.020±0.08、-0.011±0.10;FS-LASIK组分别为-0.017±0.08、-0.019±0.09、-0.031±0.10、-0.024±0.09、-0.002±0.12;术后1d和1wk,SMILE组视力低于FS-LASIK组,两组比较差异有统计学意义(P<0.05),其它时间点差异无统计学意义(P>0.05).术后1、6、12mo,SMILE组的等效球镜(spherical equivalent,SE)分别为-0.03±0.29、-0.04±0.28、-0.06±0.32D;FS-LASIK组分别为0.02±0.20、-0.01±0.29、-0.08±0.33D,两组比较术后1mo的结果差异有统计学意义(P<0.05),其余时间点两组的差异无统计学意义(P>0.05).术后3mo,SMILE组测量的偏中心切削值为0.21±0.11mm,FS-LASIK组为0.20±0.08mm,两组比较差异无统计学意义(P>0.05).结论:SMILE治疗近视及近视散光有良好的有效性、可预测性、稳定性和安全性,但与FS-LASIK比较,术后早期视力恢复慢.     

飞秒激光准分子激光原位角膜磨镶术与前弹力层下激光角膜磨镶术术后干眼的对比

目的：：探讨飞秒激光准分子激光原位角膜磨镶术( laser in situ keratomileusis,LASIK)与前弹力层下激光角膜磨镶术( sub-Browman’s keratomileusis,SBK)术后干眼及泪膜功能的变化。方法：回顾性分析2013-01/09在我院接受近视手术患者220例440眼。其中126例252眼为飞秒LASIK组,94例188眼为SBK组,分别观察两组术前及术后1wk,1、3、6mo的角膜荧光素染色( fluorescence staining,FL)、泪膜破裂时间(tear break-up time,BUT)、泪液分泌试验(SchirmerⅠtest,SⅠt)的变化。结果：飞秒LASIK组和SBK组术后1 wk和1 mo荧光素染色评分,两组间比较差异有统计学意义(P<0.05),术后3mo和6mo两组间比较差异无统计学意义(P>0.05)。术后1wk和1mo BUT,两组间比较差异有统计学意义( P<0.05),术后3mo和6mo两组间比较差异无统计学意义(P>0.05)。术后1 wk、1 mo和3 mo Schirmer Ⅰ试验两组间比较差异有统计学意义(P<0.05),术后6mo两组间比较差异无统计学意义(P>0.05)。结论：飞秒LASIK和SBK术后患者早期均有不同程度的干眼,但飞秒LASIK术后的泪膜功能恢复较SBK快。     

Ocular toxicity of experimental intravitreal itraconazole

We investigated itraconazole, a new triazole antifungal agent that poorly penetrates ocular tissues after oral administration. We injected itraconazole in doses from 10 to 100 micrograms dissolved in 100% dimethyl sulfoxide into the eyes of New Zealand rabbits. Ocular toxicity studies performed five weeks after administration showed no substantial retinal or histopathologic changes in eyes injected with either 100% dimethyl sulfoxide or 10 micrograms of itraconazole. Higher doses caused focal areas of retinal necrosis. Our results indicated that intravitreal doses of 10 micrograms or less of itraconazole may be beneficial in the treatment of fungal endophthalmitis.     

Post-traumatic fatal <Emphasis Type="Italic">Nattrassia mangiferae</Emphasis> orbital infection

Nattrassia mangiferae orbital infection is a very rare disease that is usually curable. We report the first case of a fatal N. mangiferae orbital infection following a thorn penetration injury in a patient who also had diabetes mellitus, heart failure, and cirrhosis.     

Analysis of three genes in Leber congenital amaurosis in Indonesian patients

PURPOSE: To assess the frequency, the pattern of disease causing mutations, and phenotypic variations in patients with Leber congenital amaurosis (LCA) from Indonesia. PATIENTS AND METHODS: Twenty-one unrelated index cases with a clinical diagnosis of LCA were screened for mutations in the coding sequence of RetGC1, RPE65 and AIPL1 gene with single strand conformation polymorphism analysis followed by direct sequencing and restriction enzyme digestion. RESULTS: Four novel disease causing mutations were identified: Three in the RPE65 gene (106del9bp, G32V and Y435C) in two of 21 index cases and one in the AIPL1 (K14E). Two of them were homozygous and one was compound-heterozygous. No disease causing mutation was identified in RetGC1. CONCLUSIONS: The four novel disease causing mutations identified in this study confirmed the diagnosis of LCA which has not been recognized before in Indonesia. The frequency of RPE65 mutations was 9.5%; and of AIPL1 mutations 4.8%. This was in general accordance with previous studies reported from other countries. Unlike in those studies, no disease causing RetGC1 mutations could be identified in our patients. Phenotypically, the RPE65 and AIPL1 mutations identified in this study caused nearly total blindness by the second decade of life, but had a different onset of symptoms. The patients with the RPE65 mutations retained some useful visual function until the end of the first decade, which progressed to total blindness during the second decade of life, whereas the (homozygous) AIPL1 mutation was associated with nearly total blindness from infancy on. Therefore, RPE65 mutations have to be considered to cause early onset severe retinal degeneration (EOSRD), and AIPL1 mutations a form of LCA.     

Recent developments in the prevention and treatment of congenital toxoplasmosis

The manifestations of congenital toxoplasmosis vary considerably in degree, characteristics and time of onset. Options for prevention of the disease include the appropriate disposal of cat litter and the avoidance of ingestion of both contaminated food and undercooked meat by pregnant women. Immunisation of the domestic cat population is a consideration for the future. Alternatively, immunisation of sero-negative pregnant women awaits the introduction of an effective and safe reagent. Current treatment modalities are not universally effective and new drugs are the subject of active development and research. Screening of pregnant women or perhaps newborn infants are potential options but the cost effectivity has yet to be established in many countries and the results of treatment during pregnancy and early childhood are encouraging but are as yet unproven. The majority of patients with congenital toxoplasmosis eventually develop toxoplasmic retinochoroiditis. Current treatment options for this condition are outlined. Acquired immune deficiency syndrome (AIDS) may, in some cases, represent a recrudescence of congenital intracerebral infection. Current treatment strategies for this condition are discussed.     

Epi-LASIK和LASIK治疗近视散光的早期疗效对比观察

目的:探讨分析角膜微型刀上皮瓣下准分子激光原位角膜磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)和准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗近视散光的疗效。方法:近视散光行Epi-LASIK治疗的患者32例64眼,LASIK治疗的患者63例126眼,将患者根据柱镜度数分为2组:Ⅰ组(柱镜-0.25～-2.75D,Epi-LASIK 20例、LASIK 48例)、Ⅱ组(柱镜-3.00～-5.00D,Epi-LASIK 12例、LASIK 15例)。随访6mo观察两种术式的疗效。对比两组患者的术后裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、残余散光度、角膜愈合情况、眼压及角膜地形图等。结果:术后6mo,Ⅱ组中UCVA较术前明显提高,EpiLASIK为21眼(87.5%),LASIK为19眼(63.3%),两术式相比较差异有显著性(χ2=4.055,P<0.05);残余散光度Epi-LASIK为-0.41±0.30D,LASIK为-0.74±0.36D,两术式相比较差异有显著性(t=2.672,P<0.05);角膜散光Epi-LASIK为0.63±0.34D,LASIK为0.81±0.52D,两术式相比较差异有显著性(t=2.234,P<0.05)。结论:Epi-LASIK治疗≥-3.00D散光与LASIK相比具有更好的效果和预测性。     

Acanthamoeba keratitis

A case of amoebic keratitis is described in a 34-year-old male patient who got glass wool dust in his eye. The keratitis ran a chronic course over more than 8 months and was resistant to topical antibiotics, steroids and antiviral drugs. A perforating keratoplasty was performed, and 1 year later the condition appears satisfactory. Histopathological examination of the corneal disc revealed many encysted amoebae which were classified as belonging to the genus Acanthamoeba.This is the first case of amoebic keratitis to be recorded in Belgium. The report includes a review of the literature on the subject.