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A 68 year old diabetic female with contact lens use was referred for non-healing corneal ulcer with negative culture. Confocal confirmed acanthamoeba and fungal keratitis. She was medically treated with worsening hypopyon and progression to scleral involvement. A 14 mm sclerokeratoplasty with PI was performed; the crystalline lens remained in place with plan for post-op chronic immunosuppression.