Deep Anterior Lamellar Keratoplasty for Acanthamoeba Keratitis Complicating the Use of Boston Scleral Lens

Abstract

This is the first reported case of Acanthamoeba keratitis (AK) in a Boston scleral lens user. Consequently, the risk factors and treatment for AK need to be addressed in this unique case. We conducted a retrospective case study of a 45-year-old man using Boston scleral lens diagnosed with AK. Risk factors for infection and management of the condition were assessed. This 45-year old Boston scleral lens user's risk factors for developing AK included dry eye syndrome, autologous serum tear use, potential tap water exposure, and long-term systemic corticosteroid use. His infection was refractory to medical management and required deep anterior lamellar keratoplasty for curative treatment. Ophthalmologists should have a higher level of suspicion for AK in all scleral lens users and consider the use of deep anterior lamellar keratoplasty for refractory cases.