Acanthamoeba and Fungal Keratitis in a Woman With a History of Intacs Corneal Implants

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Abstract
To report a case of corneal perforation secondary to Acanthamoeba and fungal keratitis in a patient with a history of Intacs corneal implants. The patient’s history, clinical presentation, and pathologic analysis were reviewed. A 56-year-old woman with keratoconus was referred to the university eye center for a corneal perforation secondary to a chronic corneal ulcer initially diagnosed as herpes simplex keratitis. The patient had Intacs inserted in the same eye 14 months earlier, but had them removed approximately 1 month before her visit. After emergency keratoplasty, the patient’s corneal tissue was sent for histopathologic examination, which showed an Acanthamoeba and fungal coinfection. Atypical sources of keratitis should be considered in patients with a chronic corneal ulcer and a history of Intacs corneal implants.