Evaluation of Intracameral Amphotericin B in the Management of Fungal Keratitis: Randomized Controlled Trial.

PURPOSE: To evaluate the efficacy and safety of intracameral amphotericin B (ICAMB) in the management of fungal keratitis.

METHODS

In total, 45 eyes with smear-confirmed fungal keratitis with hypopyon were randomized into three treatment groups: Group I (topical antifungal treatment + oral antifungal); Group II (topical antifungal treatment + ICAMB + oral antifungal); and Group III (topical antifungal treatment + drainage of hypopyon + ICAMB + oral antifungal). The main outcome measures were treatment success rate, time to heal, visual acuity gain, and presence of complications.

RESULTS

There were no differences in the treatment success rates (p = 0.66), time to healing (p = 0.18), or mean final visual acuity (logMAR) (p = 0.8) between the three groups. The major complication observed was increased incidence of cataract in group III (40%), though it was statistically insignificant.

CONCLUSIONS

ICAMB does not offer any benefit over topical antifungal therapy when performed alone or associated with drainage of hypopyon.