Recurrence of Acanthamoeba Keratitis after Deep Anterior Lamellar Keratoplasty

Purpose: To report a case of bilateral acanthamoeba keratitis with recurrence after keratoplasties Case report: Here we report a case with bilateral acanthamoeba keratitis who initially responds to medical treatment, after discontinuation of treatment the disease flared up and not responded to medical therapy so superficial keratectomy was done and medical treatment continued and the ulcer improved. Eleven months later only central corneal scar remained. For restoration of vision conventional lamellar keratoplasty (LK) and deep anterior lamellar keratoplasty (DALK) accomplished for left and right eye respectively. The left eye had uncomplicated post operative course, but in the right eye three weeks after DALK recurrence of acanthamoeba keratitis occurred, the keratitis not responded to medical treatment and therefore therapeutic penetrating keratoplasty (PK) was done. In last visit the graft was clear and the patient had uncomplicated postoperative course. Conclusion: PK and postoperative antiamoeba treatments are appropriate treatments for restoration of vision in acanthamoeba keratitis. It is recommended that for prevention of recurrence antiamoeba agent to be continued for at least two months.