Combined topical and intracameral injection of Amphotericin B versus topical Amphotericin B in management of fungal keratitis in MOC, Egypt

Document Type : Original Articles

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Mansoura Ophthalmic Center, Mansoura University

Abstract

Abstract:
Fungal keratitis is one of the leading causes of blindness in developing countries in this study we evaluated the efficacy of a combination of topical and intracameral injections of amphotericin B in the treatment of severe fungal keratitis.
Patients and methods: This prospective, comparative interventional randomized study included 40 patients of fungal keratitis attended outpatient clinic of MOC, faculty of medicine Mansoura University ,Egypt, in the period from January 2017 to December 2018.The patients were randomly divided into 2 groups: Group A: underwent only topical amphotrcine B. Group B: underwent combined topical & intracameral injection of antimicrobials. Patients were followed up at 1 day, 1 week, 2W, first month ,then monthly till the 6th month.
Results: Both groups were sex and age matched .Trauma was the most common risk factor recorded .Asperigulus was the commonest causative agent (85%).in group A ,the size of corneal ulcer improved from 32.44±19.37to 29.71±17.16 at 1st week to 18.81±10.04 in the 1st month, in group B the ulcer size decreased from 30.24±16.09 to 21.81 ±11.04(p <0.001)in the 1st week the ulcer achieved complete healing within 3 months. The mean duration for the complete healing in group A ,was 48.82 ± 5.31 days while the mean duration in group B, that was 29.59 ± 3.24 days (p < 0.001). Conculsions: intrcameral Amphotrecine B injection is safe and effective technique in treatment of fungal keratitis.

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