Nekrotisierende Skleritis nach Akanthamöbenkeratitis

Nodular scleritis and necrotizing scleritis are rare complications of acanthamoeba keratitis. This article presents the case of a 61-year-old female patient who had suffered from persistent keratitis in the right eye for more than 4 months. The patient was initially treated with propamidine isethionate and polyhexamethylene biguanide eye drops. A penetrating limbo-keratoplasty was performed. Examination of the corneal explant showed acanthamoeba cysts. In the following 5 months the sclera showed recurrent abscesses. A total of two thermal cauterizations and three amniotic membrane grafts were carried out. To our knowledge, this is the first case of sclerokeratitis after acanthamoeba keratitis which was treated with a combination of thermal cauterization and amniotic membrane transplantation. Further studies are necessary to investigate this procedure as an alternative to the established cryotherapy.