{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:40:55Z","timestamp":1790167255376,"version":"4.1.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100021262","name":"Light for Sight Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021262","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eye and Vis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p><jats:italic>Acanthamoeba<\/jats:italic> keratitis (AK) is the most challenging corneal infection to treat, with conventional therapies often proving ineffective. While photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) with riboflavin\/UV-A has shown success in treating bacterial and fungal keratitis, and PACK-CXL with rose bengal\/green light has demonstrated promise in fungal keratitis, neither approach has been shown to effectively eradicate AK. This case study explores a novel combined same-session treatment approach using both riboflavin\/UV-A and rose bengal\/green light in a single procedure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 44-year-old patient with active AK in the left cornea, unresponsive to 10\u00a0months of conventional treatment according to American Academy of Ophthalmology (AAO) guidelines, was treated using same-session sequential PACK-CXL with riboflavin\/UV-A (365\u00a0nm) irradiation (10\u00a0J\/cm<jats:sup>2<\/jats:sup>) and rose bengal\/green light (522\u00a0nm) irradiation (5.4\u00a0J\/cm<jats:sup>2<\/jats:sup>) in a single setting. The procedure was repeated twice due to persistent signs of inflammation and infection. After three combined same-session PACK-CXL treatments, the patient\u2019s cornea converted to a quiescent scar, and symptoms of ocular pain, photophobia, epiphora, and blepharospasm resolved. Confocal microscopy revealed no detectable <jats:italic>A<\/jats:italic><jats:italic>canthamoeba<\/jats:italic> cysts. The patient currently awaits penetrating keratoplasty.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The same-session combination of riboflavin\/UV-A and rose bengal\/green light PACK-CXL effectively treated a patient with confirmed AK that was resistant to conventional medical therapy, suggesting that using two chromophores in a single procedure may represent a future treatment alternative for AK.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40662-024-00420-2","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:02:04Z","timestamp":1735862524000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Same-session dual chromophore riboflavin\/UV-A and rose bengal\/green light PACK-CXL in Acanthamoeba keratitis: a case report"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8935-4558","authenticated-orcid":false,"given":"Farhad","family":"Hafezi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrg","family":"Messerli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio A.","family":"Torres-Netto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan-Ji","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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Farhad Hafezi is the Chief Medical Officer of EMAGine AG, a company producing a CXL device and he is an editorial member of Eye and Vision. The other authors have no proprietary or commercial interest in any of the materials discussed in this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"2"}}