Title : Topical and intrastromal Amphotericin B in refractory fungal corneal ulcer patients: A prospective study
Abstract:
Purpose:
Corneal ulcer is one of the important ophthalmic condition causing significant morbidity especially in the developing countries. Bacteria and fungi are frequently responsible for suppurative corneal ulcers especially in the developing countries.The present study aimed to know the safety and efficacy of topical and intrastromal injection of Amphotericin B in the management of non-responding fungal corneal ulcer patients.
Methodology:
It was a hospital based prospective, non-randomized, analytical study. Thirty patients of non-responding fungal corneal ulcer of any age group, of either sex were studied.
Cases were studied in terms of clinical examinations, relevant investigations, appropriate treatment and documentation.
Results:
All 30 patients were given topical Amphotericin B. Out of them, 10 patients (33.33%) responded well and healed. Twenty patients not responsed to topical Amphotericin B. Out of them 3 patients did not give consent for intrastromal injection and rest 17 patients were given intrastromal Amphotericin B injection. Post-intrastromal injection, all patients were continued with drops of topical Amphotericin B 0.15%, 1% Atropine eye drop thrice a day, antibiotic eye drop Besifloxacin 0.6% and tablet fluconazole 150mg OD. Out of them 15 patients (88.23%) responded well and healed and remaining 2 were treated with other treatment modalities.
Conclusion:
Topical Amphotericin B eye drop was found less effective in management of non-responding fungal corneal ulcer patients, because of poor penetration of the drug topically. Intrastromal injections of Amphotericin B was safe and effective in the treatment of this pathology.
