Purpose: To evaluate the efficacy of intracameral amphotericin B injection in the adjunctive management of keratomycosis with probable intraocular extension not responding to conventional antifungal therapy.
Methods: Fourteen eyes of 12 patients with fungal keratitis that did not respond to initial treatment with topical and intravenous fluconazole and oral itraconazole were treated with up to 5 intracameral injections of 5 microg of amphotericin B. Six eyes received one injection, and 8 required subsequent injections.
Results: Twelve eyes responded to amphotericin B therapy, including 5 that healed with a central corneal scar and 8 that healed with a peripheral opacity. Two eyes progressed to evisceration. Four eyes developed anterior subcapsular cataract after intracameral amphotericin B.
Conclusions: Intracameral amphotericin B may be an effective adjunctive treatment of fungal keratitis unresponsive to conventional antifungal therapy, although cataract may occur.