{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:10:07Z","timestamp":1756311007663,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,5,6]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n                  <jats:italic>Acanthamoeba<\/jats:italic> keratitis (AK) is a rare but potentially sight-threatening complication of corneal collagen crosslinking (CXL) for keratoconus. In this report, we describe an early adolescent male who underwent routine CXL for progressive keratoconus in his left eye. Preprocedural left visual acuity (VA) was 6\/9. At day 5 postprocedure, multifocal corneal infiltrates were identified. Corneal scrape, bandage contact lens cultures and herpetic and <jats:italic>Acanthamoeba<\/jats:italic> PCR were negative. In vivo, confocal microscopy (IVCM) identified <jats:italic>Acanthamoeba<\/jats:italic> cysts within the corneal stroma. Intensive amoebicidal therapy was initiated, but recovery was complicated by significant inflammation, resulting in widespread aggressive corneal vascularisation necessitating topical steroids and steroid-sparing agents. At 10 months, his left VA was 6\/24. This report emphasises the importance of maintaining a high index of suspicion for AK in cases of post-CXL microbial keratitis and highlights the diagnostic value of IVCM, particularly in culture-negative and PCR-negative cases.<\/jats:p>","DOI":"10.1136\/bcr-2023-257279","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T22:45:16Z","timestamp":1716331516000},"page":"e257279","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic utility of in vivo confocal microscopy in <i>Acanthamoeba<\/i> keratitis following corneal crosslinking"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8696-9546","authenticated-orcid":false,"given":"Cheng Fei","family":"Kong","sequence":"first","affiliation":[{"name":"The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"},{"name":"Westmead Hospital, Westmead, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Go","sequence":"additional","affiliation":[{"name":"The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"},{"name":"Westmead Hospital, Westmead, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saadiah","family":"Goolam","sequence":"additional","affiliation":[{"name":"The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"},{"name":"Westmead Hospital, Westmead, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Season","family":"Yeung","sequence":"additional","affiliation":[{"name":"Westmead Hospital, Westmead, New South Wales, 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