الفهرس 
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Abstract
The aim of this study was to compare the use of topical amphotericin B (0.5mg/mL) eye DROPs with intrastromal injection of amphotericin B (0.05mg/mL) in dealing with cases of fungal keratitis.
Methods: The study was performed at the Ophthalmology Department, Zagazig University and included 30 eyes of 30 patients who presented clinically with fungal keratitis. Laboratory investigations were performed, including direct microscopy of corneal smear using gram staining and culture of corneal specimens using Saboraud agar media and nutrient agar media. Patients were classified into two groups: The first group comprising 15 eyes treated with topical amphotericin B eye DROPs (0.05 %). The second group comprising 15 eyes treated with intrastromal injection of amphotericin B (0.005 %)
Results: Patients treated with topical amphotericin B eye DROPs (0.05 %), the healed cases (47%), mean healing duration was 44 days (S.D.+ 3.8), all healed patients in this group were not diabetics, and not reported to have systemic diseases. The results revealed that, young aged patients showed final improvement within 26 to 52 days. In middle aged patients, cases showed final improvement within 31 to 38 days. In old aged patients, cases showed final improvement within 58 to 30 days, one patient was presented with pigmented ulcer, showed final improvement after 58 days. While patients treated with intrastromal injection of amphotericin B (0.005 %), the healed cases (67%), mean duration was 30 days (S.D.+ 9.8), all healed patients in this group were not diabetics, and did not have systemic diseases.
The results revealed that, young aged patients showed excellent final improvement in 14 and 15 days. While in middle aged patients, one case showed final improvement in 33 days. In old aged patients, 3 cases showed final improvement in 38, 40 and 45 days.
In the current comparative study between amphotericin B eye DROPs and intrastromal injection in treatment of fungal keratitis, the result recorded that amphotericin B was effective and safe in both, however it must be considered the drug of choice in non diabetics and non immune compromised patients. On the other hand, intrastromal injection showed more advantage in healing duration especially in keratomycosis in young aged patients.
Conclusion: The treatment with amphotericin B intrastromal injection was more efficient (according to the percentage and the duration of healing of the ulcers) than the use of topical amphotericin B eye DROPs. Importantly, the treatment by intrastromal injection, rather than it showed more healing cases with shorter duration than topical eye DROPs, it achieved an excellent outcome in young aged patients. Also, it reduced the cost and shortened the hospital stay.