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.
RCT Entities:
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.
Authors: Hazal Boral; Anne van Diepeningen; Elif Erdem; Meltem Yağmur; G Sybren de Hoog; Macit Ilkit; Jacques F Meis; Abdullah M S Al-Hatmi Journal: Mycopathologia Date: 2018-06-21 Impact factor: 2.574