Treatment of severe fungal keratitis with subconjunctival amphotericin B.

PURPOSE: To report the beneficial properties of subconjunctival amphotericin B as an adjunctive therapy in patients with severe fungal keratitis.

METHODS

Case reports and review of medical literature. Four patients with advanced fungal keratitis were treated with repeated injections of subconjunctival amphotericin B in addition to topical and systemic antifungal treatment.

RESULTS

Two to 8 injections were given to each patient. All patients showed rapid clinical improvement after the injections. No serious adverse effects were observed. However, all patients experienced pain during the injections.

CONCLUSIONS

Subconjunctival injections of amphotericin B are useful as an adjunctive treatment of advanced fungal keratitis. This treatment assures compliance and may be an alternative to avoid a surgical intervention in an acute stage of advanced fungal keratitis. More cases are needed to validate our findings.