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ORIGINAL ARTICLE
Year : 2016  |  Volume : 29  |  Issue : 3  |  Page : 601-605

Topical amphotericin B versus subconjunctival fluconazole injection in the management of fungal keratitis


1 Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia Governorate, Egypt
2 Department of Shebin El Kom Ophthalmology Hospital, Menoufia University, Menoufia Governorate, Egypt

Correspondence Address:
Eman F Mottawea
Department of Shebin El Kom Ophthalmology Hospital, Menoufia University, Ahmed Abu Sena Street, Shebin El Kom, Menoufia, 32511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.198726

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Objectives The aim of this study was to compare the use of topical amphotericin B (0.5 mg/ml) eye drops with the use of subconjunctival injection of fluconazole (2 mg/ml) in dealing with cases of fungal keratitis. Background Fungal keratitis is considered one of the serious ocular infections that lead to ocular morbidity and visual loss, especially in developing countries. Materials and methods This study was carried out on 50 eyes of 50 patients with resistant corneal ulcers attending Menoufia University Hospital outpatient clinic between July 2012 and February 2014. Results Group  1 included 25 cases treated with topical amphotericin B; the study revealed healing of corneal ulcers in six cases (24%), and 19 cases (76%) developed  complications. Group 2 included 25 cases treated with subconjunctival fluconazole injection; the study revealed statistically significant result (P < 0.01) of healing of corneal ulcers in 23 cases (92%), and in two cases (8%) complications developed. Conclusion and recommendations Fungal keratitis has proven to be a continually challenging ocular disease for patients, providers, and society. The most common etiologic agents have been identified to be diabetes and plant ocular trauma. Our study states that the administration of a subconjunctival injection of fluconazole was more effective compared with the administration of topical amphotericin B eye drops, as evidenced by the healing of the fungal corneal ulcer and shorter duration of healing.


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