Background Resistant infected corneal ulcers of fungal origin represent a serious problem with impaired visual outcome in many instances. Many procedures like voriconazole injection, corneal debridement, and amniotic membrane transplantation (AMT) may be used to accelerate healing and to improve outcome. Aim To compare between intrastromal voriconazole injection withAMT and corneal debridement with AMT as augmented treatment for keratomycosis. Patients and methods Mycotic keratitis cases were divided in 2 groups 15 cases each. In one group, intrastromal voriconazole injection and AMT in the same setting was done and in the other group, corneal debridement and AMT in the same setting was done. Our cases included 23 cases with mixed infection and 7 cases were pure fungal keratitis as proven with culture results. In the voriconazole group, intrastromal injection followed by AMT was done while in debridement group, corneal debridement was done to expose the ulcer bed followed by AMT in the same settings. Results Healing was achieved in both groups in 2–6 weeks in all cases. Healing was reached in more than 85% of cases of voriconazole group by the 4th week, while 40% of cases of the debridement group achieved healing by the same time. Visual functions outcome was enhanced in more than 33% of cases of voriconazole group while in 20% of cases of debridement group only. Conclusions Intrastromal voriconazole injection with AMT gives better results than corneal debridement with AMT for treatment of resistant mycotic keratitis.
Khater et al. (Wed,) studied this question.