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  • Employing endoscopic guidance for placement of a black diaphragm aniridia intraocular lens following destructive Acanthamoeba sclerokeratitis

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Employing endoscopic guidance for placement of a black diaphragm aniridia intraocular lens following destructive Acanthamoeba sclerokeratitis
  1. A M Poothullil1,
  2. S D McLeod1,2,
  3. S Lin1
  1. 1Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
  2. 2The Francis I Proctor Foundation University of California San Francisco, San Francisco, CA, USA
  1. Correspondence to: Dr S D McLeod Department of Ophthalmology, 10 Koret Way, K-301, San Francisco, CA 94143, USA; smcleoditsa.ucsf.edu

https://doi.org/10.1136/bjo.2003.031583

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    Anterior segment reconstruction can be particularly challenging when anatomic landmarks are lost. We describe a case of destructive Acanthamoeba sclerokeratitis resulting in aniridia, aphakia, loss of limbal architecture, and corneal opacification that was approached surgically with penetrating keratoplasty and placement of a black diaphragm aniridia intraocular lens under endoscopic guidance.

    Case report

    Our patient, a 48 year old female contact lens wearer, was diagnosed with Acanthamoeba keratitis in June 2000. Before our evaluation, she had been treated with tobramycin and dexamethasone ointment, topical trifluridine, oral acyclovir, oral prednisone, and topical prednisolone acetate 1%. We diagnosed Acanthamoeba keratitis and began aggressive treatment with polyhexamethyl biguanide, chlorhexidine, and oral clotrimazole. By January 2001, she was culture negative, but had developed necrotising sclerokeratitis with limbal involvement, dense corneal …

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