title: Deep anterior lamellar keratoplasty for acanthamoeba keratitis complicating the use of Boston scleral lens.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Kansas School of Medicine (B.F.); and Department of Ophthalmology (J.E.S.), University of Kansas, Kansas City, KS.
authors.forename: Bilal
authors.initials: B
authors.lastname: Farhat
authors.forename: John E
authors.initials: JE
authors.lastname: Sutphin
mesh_terms: D015823:Acanthamoeba Keratitis / Q000209:etiology / Q000601:surgery; D003261:Contact Lenses / Q000009:adverse effects*; D016039:Corneal Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors