[Acanthamoeba keratitis in hard contact lens wearers. Case report and review of the literature of 108 cases].

We report on a 49 year old woman with Acanthamoeba keratitis. She was wearing hard contact lenses and had a history of a minor trauma when removing her lens after a visit of a hot tub. She had the typical corneal ring infiltrate and complained about severe pain. The medical treatment was uneffective. Because of progressive deterioration penetrating keratoplasty was necessary. After a rekeratoplasty because of a recurrent infection on the transplant the patient has done well now for 3 years. The diagnosis was made on histological grounds. We report on 108 patients of the literature: 8 (7%) patients were wearing hard contact lenses; 19 (17%) remembered a trauma; 4 (3.7%) had visited a hot tub; 61 (56%) needed penetrating keratoplasty, 11 (10%) rekeratoplasty; 5 (4.6%) eyes were enucleated; in 21 (19%) patients the diagnosis was made on histological grounds.