title: Efficacy of intracameral amphotericin B injection in the management of refractory keratomycosis and endophthalmitis.
abstract: 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.
authors: Department of Ophthalmology, Izmir Atatürk Training and Research Hospital, Izmir, Turkey. safiyekucukbay@hotmail.com
authors: Safiye
authors: S
authors: Yilmaz
authors: Melih
authors: M
authors: Ture
authors: Ahmet
authors: A
authors: Maden
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B