title: Efficacy Profile of Intracameral Amphotericin B. The Often Forgotten Step.
abstract: OBJECTIVE
  The objectives of this study were to assess visual and structural outcomes in mycotic keratitis after conventional treatment (topical and systemic antifungals) and intracameral amphotericin B (ICAMB), and to evaluate any complications.
  
  
  METHODS
  This was a prospective, nonrandomized, nonblinded interventional study.
  
  
  METHODS
  This study was conducted on 104 eyes of 104 patients with fungal corneal ulcers. Patients were categorized into 2 groups: group A, who received conventional topical and systemic antifungal medications, and group B, who received ICAMB in the dose of 5 to 10 μg in 1 mL of 5% dextrose. Response to treatment was evaluated. Results of the 2 groups were compared with appropriate statistical indices.
  
  
  RESULTS
  The mean final visual acuity in patients in group B receiving ICAMB was 1.22 ± 0.31 logMAR units. The improvement in mean visual acuity was 1.40 ± 0.2 logMAR units. In group A, mean visual outcome was 1.25 ± 0.73 logMAR units. There was an improvement by 0.55 ± 0.30 logMAR units. Healing with varying degrees of opacification occurred in a significant number of patients (81.48%) treated with ICAMB as compared with conventional treatment (Z = 2.24, P < 0.05). Complications, such as sloughing, occurred in significantly fewer patients treated with ICAMB as compared with conventional treatment (Z = 2.29, P < 0.05).
  
  
  CONCLUSIONS
  In cases of keratomycosis where response to local and systemic antifungal treatment is not evident after 7 days, ICAMB can be safely administered to prevent the progression of ulcers and the development of complications.
authors.affiliation: From the Regional Institute of Ophthalmology, Gandhi Medical College, Bhopal, India.
authors.forename: Bhavana
authors.initials: B
authors.lastname: Sharma
authors.forename: Preeti
authors.initials: P
authors.lastname: Kataria
authors.forename: Reena
authors.initials: R
authors.lastname: Anand
authors.forename: Rachna
authors.initials: R
authors.lastname: Gupta
authors.forename: Kavita
authors.initials: K
authors.lastname: Kumar
authors.forename: Salil
authors.initials: S
authors.lastname: Kumar
authors.forename: Richa
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D003320:Corneal Ulcer / Q000188:drug therapy*; D015821:Eye Infections, Fungal / Q000188:drug therapy*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010866:Natamycin / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D014792:Visual Acuity
chemical_list: D000935:Antifungal Agents; D009883:Ophthalmic Solutions; D000666:Amphotericin B; D010866:Natamycin; D015725:Fluconazole