Selection of Best Topical Medication for Treating Fungal Corneal Ulcers in Our Community

Abstract

 Object:To determine the best available topical antifungal dntg for treating fungal corneal ulcers in our community. Study Design: Prospective randomized control study. Place & Duration: Department of Ophthalmology Peoples university Hospital Nawabshah and Ghularn Muhammad Mehar Medical College Sukkhur during October 2013 to October 2014. Material & Methods: Patients with clinical signs mimicking fungal keratitis were admitted in Eye department. Corneal scraping under topical anesthesia was taken from the base and edges of ulcer and was subjected to KOH preparation for direct microscopy. Only patients with positive stain were included in the study. Patients were subdivided into three groups A. B, and C (50 patients each) according to drug used. Group A were given Topical Natamycin 5%, Group B were given Topical reconstituted Fluconazole 1%, Group C were given Topical reconstituted Amphotericin B 0. 1 5%,Clinical improve-ment was measured on the basis of reduction of the density of the suppuration, reduction in cellular infiltrate and edema in the surrounding stroma, reduction in anterior chamber inflammation, progressive re-epithe I ization, and Loss of the feathery perimeter ofthe stromal inflammation. Results: Out of 50 patients with clinical and laboratory proven fungal keratitis in group A. 44 healed without any consequence by 12 weeks, 6 patients did not responded well and ended up with corneal perforation, endophthalmitis or surgical intervention. In group B out of 50 patients 38 healed without any consequence, while 12 ended up with corneal perforation. endophthalmitis or surgical intervention. In group C out of 50 only 18 patients had a good healing by 12 weeks while remainder did not responded. Conclusion: Natarnycin 5% is still the drug of choice for fungal keratitis in our community as most of them are of filamentous origin.