Shao Yi, Yu Yao, Pei Chong-Gang, Tan Ye-Hui, Zhou Qiong, Yi Jing-Lin, Gao Gui-Ping
Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
Int J Ophthalmol. 2010;3(3):257-60. doi: 10.3980/j.issn.2222-3959.2010.03.18. Epub 2010 Sep 18.
To evaluate the therapeutic efficacy of intracameral amphotericin B (ICAMB) injection in the treatment of keratomycosis.
The study design was a prospective controlled clinical trial. A total of 60 eyes of 60 patients were divided into two groups, 30 in the ICAMB injection group (group A) and 30 in the control group-topical application amphotericin B (group B). Serial measurements of the size of the keratomycosis-namely, two maximum linear dimensions perpendicular to each other, and the area and perimeter was done at start of therapy and follow up on day 3, 7, and 21. Rate of healing of the keratomycosis were measured as percentage decrease from the baseline parameter at each subsequent follow up. The data were analyzed by the non-parametric Wilcoxon rank sum test.
The mean time to disappearance of hypopyon was 9.6±9.2 (range:1-26) days in group A and 26.8±20.8 (range:14-62) days in group B (P=0.03). The median percentage decrease in the size of the keratomycosis was significantly greater than that in the cord serum group at day 21(P<0.05) when measured in terms of the area and perimeter. A greater number of patients showed complete re-epithelialization in group A (n=27) than in group B (n=14) (P<0.05). None of the patients reported any side effects or discomfort with either treatment.
ICAMB injection leads to faster healing of the keratomycosis refractory to all medical management and reducing time to disapperence of hypopyon compared to topical application amphotericin B.
评估前房内注射两性霉素B（ICAMB）治疗角膜真菌病的疗效。
本研究设计为前瞻性对照临床试验。60例患者的60只眼共分为两组，ICAMB注射组（A组）30只眼，对照组——局部应用两性霉素B（B组）30只眼。在治疗开始时以及治疗后第3、7和21天，对角膜真菌病的大小进行系列测量，即相互垂直的两个最大线性尺寸、面积和周长。角膜真菌病的愈合率以每次后续随访时相对于基线参数的百分比下降来衡量。数据采用非参数Wilcoxon秩和检验进行分析。
A组前房积脓消失的平均时间为9.6±9.2（范围：1 - 26）天，B组为26.8±20.8（范围：14 - 62）天（P = 0.03）。以面积和周长衡量，在第21天时，A组角膜真菌病大小的中位百分比下降显著大于B组（P < 0.05）。A组（n = 27）完全上皮化的患者数量多于B组（n = 14）（P < 0.05）。两组患者均未报告任何副作用或不适。
与局部应用两性霉素B相比，ICAMB注射可使所有药物治疗无效的角膜真菌病愈合更快，并缩短前房积脓消失的时间。
