A Comparison Between Intrastromal Voriconazole and Intracameral Amphotericin B in the Treatment of Resistant Fungal Keratitis between Intrastromal voriconazole and Intracameral amphotericin B in the treatment of resistant fungal keratitis

Background: According to reports, fungus-related keratitis accounts for roughly ۵۰% of all bacterial keratitis instances involving therapeutic penetration keratoplasty, making it a significant contributor to ocular morbidity. Fungal keratitis is a difficult condition to identify and manage.Patients and Methods: A prospective investigation was carried out. A total of ۴۰ eyes from ۴۰ participants with fungal keratitis (۲۶ men and ۱۴ women) were enrolled in this study. Grouping ۲۰ eyes first go through Voriconazole intrastromal Grouping ۲۰ eyes are examined again with Amphotericin B injection.Results: Following intrastromal voriconazole administration, the satellite lesions in ۹ participants and the hypopyons in ۳ individuals in the first cohort vanished without subsequent infection or ocular rupture. After injections, the infiltration's size considerably shrank to ۵.۴۱± ۲.۲۱ mm (P <۰.۰۰۱), but the ulcer's size remained the same (۴.۲۵ ±۱.۸۳ mm, P = ۰.۰۷۱). Seven of the ۱۷ effectively hospitalized groups in the first patient received just one injection, while six received two injections, and four received three.Conclusion: The treatment of fungal keratitis is still difficult. The causes for the poor prognosis in fungal keratitis are compounded by newly emerging fungal infections and resistance to already available antifungal medications. For persistent deeply fungal corneal ulcers, intrastromal voriconazoles and intracameral amphotericin B seem to be a successful therapy option. Thus, we draw the conclusion that in some individuals, intrastromal voriconazole may be administered as a replacement for fungal ulcers that do not heal.

Keywords:

Intrastromal voriconazole , Intracameral amphotericin B , resistant fungal keratitis