Efficacy of intracameral amphotericin B injection in the management of refractory keratomycosis and endophthalmitis.
OBJECTIVE
To evaluate the efficacy of intracameral amphotericin B injection in the adjunctive management of keratomycosis with probable intraocular extension not responding to conventional antifungal therapy.


METHODS
Fourteen eyes of 12 patients with fungal keratitis that did not respond to initial treatment with topical and intravenous fluconazole and oral itraconazole were treated with up to 5 intracameral injections of 5 microg of amphotericin B. Six eyes received one injection, and 8 required subsequent injections.


RESULTS
Twelve eyes responded to amphotericin B therapy, including 5 that healed with a central corneal scar and 8 that healed with a peripheral opacity. Two eyes progressed to evisceration. Four eyes developed anterior subcapsular cataract after intracameral amphotericin B.


CONCLUSIONS
Intracameral amphotericin B may be an effective adjunctive treatment of fungal keratitis unresponsive to conventional antifungal therapy, although cataract may occur.
Yilmaz
Safiye
S
Department of Ophthalmology, Izmir Atatürk Training and Research Hospital, Izmir, Turkey. safiyekucukbay@hotmail.com
Ture
Melih
M
Maden
Ahmet
A
D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use*; D000867:Anterior Chamber / Q000187:drug effects*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001230:Aspergillus / Q000302:isolation & purification; D002176:Candida albicans / Q000302:isolation & purification; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D012008:Recurrence; D019233:Retreatment; D016896:Treatment Outcome
D000935:Antifungal Agents; D000666:Amphotericin B