title: Acanthamoeba and fungal keratitis in a woman with a history of Intacs corneal implants.
abstract: OBJECTIVE
  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.
authors.affiliation: John Moran Eye Center, Department of Ophthalmology and Vision Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA. snowslade@yahoo.com
authors.forename: D Snow
authors.initials: DS
authors.lastname: Slade
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Johnson
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Tabin
mesh_terms: D000048:Acanthamoeba / Q000302:isolation & purification; D015823:Acanthamoeba Keratitis / Q000473:pathology*; D000818:Animals; D003320:Corneal Ulcer / Q000382:microbiology* / Q000469:parasitology* / Q000601:surgery; D020878:Device Removal; D015821:Eye Infections, Fungal / Q000473:pathology*; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D015948:Keratoplasty, Penetrating; D008875:Middle Aged; D009181:Mycoses / Q000473:pathology*; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012422:Rupture, Spontaneous
chemical_list: D019904:Polymethyl Methacrylate