Efficacy of intracameral amphotericin B injection in the management of refractory keratomycosis and endophthalmitis

Cornea. 2007 May;26(4):398-402. doi: 10.1097/ICO.0b013e318030767e.


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.

MeSH terms

  • Adult
  • Aged
  • Amphotericin B / therapeutic use*
  • Anterior Chamber / drug effects*
  • Antifungal Agents / therapeutic use*
  • Aspergillus / isolation & purification
  • Candida albicans / isolation & purification
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / microbiology
  • Endophthalmitis / drug therapy*
  • Endophthalmitis / microbiology
  • Eye Infections, Fungal / drug therapy*
  • Eye Infections, Fungal / microbiology
  • Female
  • Fusarium / isolation & purification
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Mycoses / drug therapy*
  • Mycoses / microbiology
  • Recurrence
  • Retreatment
  • Treatment Outcome


  • Antifungal Agents
  • Amphotericin B