To the Editor:
We thank Dr. Iovieno and Dr. Yeung for the comments and the queries related to our study [1]. There were patients showing signs of clinical response in terms of a decrease in the size of infiltrates and anterior chamber inflammation. As they could not come for follow-up visits, we recorded their response in their last clinic visit as the final response for the analysis. We agree with your comment that complete resolution may have been observed on longer follow-up.
We had not conducted genotyping of Acanthamoeba strain to assess if it influences the variability of observed responses. None of our cases received combination therapy and so we are unable to comment on in vitro antagonism with Chlorhexidine.
Reference
Bagga B, Sharma S, Gour RPS, Mohamed A, Joseph J, M Rathi V, et al. A randomized masked pilot clinical trial to compare the efficacy of topical 1% voriconazole ophthalmic solution as monotherapy with combination therapy of topical 0.02% polyhexamethylene biguanide and 0.02% chlorhexidine in the treatment of Acanthamoeba keratitis. Eye (Lond). 2020. https://doi.org/10.1038/s41433-020-1109-4.
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Bagga, B., Sharma, S., Gour, R.P.S. et al. Response to ‘Comment on: ‘A randomized masked pilot clinical trial to compare the efficacy of topical 1% Voriconazole ophthalmic solution as monotherapy to combination therapy with topical 0.02% Polyhexamethylene biguanide and 0.02% Chlorhexidine in the treatment of Acanthamoeba keratitis’’. Eye 36, 473 (2022). https://doi.org/10.1038/s41433-021-01401-8
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DOI: https://doi.org/10.1038/s41433-021-01401-8
