Management of Recurrent Staphylococcus-Related Marginal Keratitis with Chlorhexidine-Vancomycin Combination: A 1-Year Follow-Up Case Report

Abstract Introduction: Staphylococcus-related marginal keratitis is an inflammation of the corneal periphery characterized by the presence of stromal infiltrates and blepharoconjunctivitis. Conventional treatment consists of antibiotics and corticosteroid eye drops, and recurrence is prevalent upon treatment cessation. In this case report, we present a 1-year follow-up of the results of a novel therapeutic approach for recurrent marginal keratitis using a combination of chlorhexidine and vancomycin eye drops. Case Presentation: A 34-year-old male presented with an 8-year history of recurrent staphylococcus-related marginal keratitis in his right eye, consisting of 5 acute episodes, which under a conventional treatment regimen resolved within 10–14 days. During the follow-up of his right eye, an inflammation in his left eye developed as well. Treatment with a combination of chlorhexidine at 0.02% and vancomycin at 50 mg/mL eye drops brought rapid resolution of the acute inflammation with preservation of the effect for at least 1 year. Conclusions: A combination of chlorhexidine and vancomycin eye drops may provide an effective treatment for marginal keratitis. It demonstrated rapid improvement and maintained long-term stability, with disease control observed throughout 1-year follow-up.