The diagnosis and management of keratomycoses. II. Medical and surgical management.

Medical management of 61 cases of mycotic keratitis, including the use of natamycin (pimaricine) in 53 cases, resulted in successful healing in 46 cases. A final visual acuity of 20/40 or better was achieved in 25 cases by medical therapy alone. Thirteen cases were considered medical treatment failures, and 11 necessitated therapeutic surgery. A final visual acuity of 20/70 or better was achieved in six of these cases, including five of nine therapeutic penetrating keratoplasties. In four cases, ulceration had progressed despite natamycin treatment, but fungal cultures were negative at the time of therapeutic surgery.