DR. ARCHANA SINHA

DR. SUNIL KUMAR, DR. SUCHITRA KUMARI, DR. MD. RAGHIB TAUHEED

Abstract

Purpose: To compare the efficacy of intrastromal injections of Amphotericin B and voriconazole in the treatment of resistant fungal keratitis.

Methods: 30 eyes of 30 patients who were not responding to conventional anti-fungal treatment were recruited and randomized into 2 groups. 15 eyes were treated with Intrastromal AMB (5ug/0.1ml) and 15 eyes received Intrastromal VCZ (50ug/0.1ml). Primary outcome measures were time to healing and size of scar and secondary outcome was BCVA at 3 months.

Results: The mean duration of healing was better in the Intrastromal VCZ group (42±6.2days) as compared to the Intrastromal AMB group (44±5.8 days). In ISAMB group, deep vascularisation was greater after healing than ISVCZ group.

Conclusion: Intrasromal injections can be effectively used for management of resistant cases of fungal keratitis. ISVCZ group had a faster healing while ISAMB group had a higher rate of deep vascularisation after healing.In both groups had relatively similar visual outcome.