The use of collagen shields impregnated with amphotericin B to treat Aspergillus keratomycosis.

We treated three patients with Aspergillus keratomycosis with collagen shields soaked in amphotericin B (0.50%) for 2 hours at 25 degrees C before application. These shields, replaced daily, were used in conjunction with amphotericin B (0.25%) eye drops, which were applied every 2 hours. Cultures from the eyes of all patients became negative within 15 days of treatment. Subsequently, two patients required keratoplasty. The results suggest that collagen shields prepared this way deliver an adequate concentration of amphotericin B to the cornea, aid its tolerance, and improve the prognosis of Aspergillus keratomycosis. Further studies are needed to define the minimum therapeutic concentrations necessary to inhibit the growth of the fungus and to avoid a toxic effect on the cornea.