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

PURPOSE: To report a case of corneal perforation secondary to Acanthamoeba and fungal keratitis in a patient with a history of Intacs corneal implants. METHODS: The patient's history, clinical presentation, and pathologic analysis were reviewed. RESULTS: 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. CONCLUSIONS: Atypical sources of keratitis should be considered in patients with a chronic corneal ulcer and a history of Intacs corneal implants.