前房内注射两性霉素B治疗真菌性角膜炎的评估：随机对照试验
Evaluation of Intracameral Amphotericin B in the Management of Fungal Keratitis: Randomized Controlled Trial.
作者信息
Sharma Namrata, Sankaran Preeti, Agarwal Tushar, Arora Tarun, Chawla Bhavna, Titiyal Jeewan S, Tandon Radhika, Satapathy Gita, Vajpayee Rasik B
机构信息
a Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences , New Delhi , India and.
b Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital , Melbourne , Australia.
出版信息
Ocul Immunol Inflamm. 2016 Oct;24(5):493-7. doi: 10.3109/09273948.2015.1057597. Epub 2015 Sep 23.
PURPOSE
To evaluate the efficacy and safety of intracameral amphotericin B (ICAMB) in the management of fungal keratitis.
METHODS
In total, 45 eyes with smear-confirmed fungal keratitis with hypopyon were randomized into three treatment groups: Group I (topical antifungal treatment + oral antifungal); Group II (topical antifungal treatment + ICAMB + oral antifungal); and Group III (topical antifungal treatment + drainage of hypopyon + ICAMB + oral antifungal). The main outcome measures were treatment success rate, time to heal, visual acuity gain, and presence of complications.
RESULTS
There were no differences in the treatment success rates (p = 0.66), time to healing (p = 0.18), or mean final visual acuity (logMAR) (p = 0.8) between the three groups. The major complication observed was increased incidence of cataract in group III (40%), though it was statistically insignificant.
CONCLUSIONS
ICAMB does not offer any benefit over topical antifungal therapy when performed alone or associated with drainage of hypopyon.
目的
评估前房内注射两性霉素B（ICAMB）治疗真菌性角膜炎的疗效和安全性。
方法
总共45例经涂片确诊为真菌性角膜炎且伴有前房积脓的患者被随机分为三个治疗组：第一组（局部抗真菌治疗+口服抗真菌药）；第二组（局部抗真菌治疗+ICAMB+口服抗真菌药）；第三组（局部抗真菌治疗+前房积脓引流+ICAMB+口服抗真菌药）。主要观察指标为治疗成功率、愈合时间、视力提高情况及并发症的发生情况。
结果
三组之间的治疗成功率（p = 0.66）、愈合时间（p = 0.18）或平均最终视力（logMAR）（p = 0.8）均无差异。观察到的主要并发症是第三组白内障发生率增加（40%），尽管在统计学上无显著意义。
结论
单独使用ICAMB或与前房积脓引流联合使用时，与局部抗真菌治疗相比并无任何优势。
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