{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:55:36Z","timestamp":1781330136063,"version":"3.54.1"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>This retrospective multicenter cohort study investigated the incidence, treatment, and prognostic impact of dysregulated intraocular pressure (DIOP; &gt;24 mmHg requiring therapy) in patients with acanthamoeba keratitis (AK). Eighty-one eyes from 81 patients with confirmed AK were included; co-infections were excluded. DIOP and best corrected visual acuity (BCVA) were assessed at baseline, follow-up, and after penetrating keratoplasty (PKP). Overall, 28% of eyes were managed conservatively, 46% required one PKP, and 26% required two. DIOP occurred in 4% before AK, 11% after AK onset, and 10% after the first PKP. Eyes with DIOP prior to PKP had significantly worse final BCVA compared to those without DIOP (0.5 \u00b1 0.7 vs. 1.8 \u00b1 1.1 logMAR, p &lt; 0.001) and required PKP more frequently (100% vs. 67%, p = 0.01). Time to correct diagnosis was significantly longer in the AK-associated DIOP group (64 \u00b1 50 vs. 50 \u00b1 68 days, p = 0.03). DIOP was also associated with higher rates of prior cortisone use and complications, including fixed dilated pupil, cataract, anterior synechiae, and anterior chamber irritation. Overall, DIOP represents a major complication in AK and is linked to poorer visual outcomes. Earlier therapy may help reduce DIOP and hence improve prognosis.<\/jats:p>","DOI":"10.3390\/microorganisms14061294","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:25:16Z","timestamp":1780935916000},"page":"1294","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dysregulated Intraocular Pressure in Acanthamoeba Keratitis: Clinical Associations, Therapy, and Prognosis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8642-0222","authenticated-orcid":false,"given":"Yaser","family":"Abu Dail","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center, 66424 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0423-3624","authenticated-orcid":false,"given":"Elias","family":"Flockerzi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center, 66424 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital D\u00fcsseldorf, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2034-3687","authenticated-orcid":false,"given":"Gerd","family":"Geerling","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital D\u00fcsseldorf, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Bock","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital D\u00fcsseldorf, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Reinhard","sequence":"additional","affiliation":[{"name":"Eye Center at Medical Center, University of Freiburg, 79098 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"B\u00f6hringer","sequence":"additional","affiliation":[{"name":"Eye Center at Medical Center, University of Freiburg, 79098 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Maier","sequence":"additional","affiliation":[{"name":"Eye Center at Medical Center, University of Freiburg, 79098 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00f3ra","family":"Szentm\u00e1ry","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary"},{"name":"The Institute for Experimental Ophthalmology, Saarland University, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3728-9958","authenticated-orcid":false,"given":"Cristian","family":"Munteanu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center, 66424 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-8204","authenticated-orcid":false,"given":"Berthold","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center, 66424 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loay","family":"Daas","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center, 66424 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1051\/parasite\/2015010","article-title":"An Update on Acanthamoeba Keratitis: Diagnosis, Pathogenesis and Treatment","volume":"22","author":"Khan","year":"2015","journal-title":"Parasite"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/S0140-6736(74)90285-2","article-title":"Amoebic Infection of the Eye","volume":"2","author":"Nagington","year":"1974","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1038\/s41433-020-01339-3","article-title":"Infectious Keratitis: An Update on 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