Therapeutic surgeryinfailures ofmedical treatment forfungal keratitis

Before theuseofNatamycin (Pimaricin), iIoutof20 Fusarium ulcers diagnosed attheBascomPalmerEye Institute andreported byJones, Sexton, andRebell (I969), necessitated therapeutic surgerybecause of failures ofmedical treatment. Despite elimination of active fungal disease in13 outofI5keratoplasties, Sanders (1970) foundthatuseful vision was retained inonlythree cases. Since Natamycin becameavailable Polack, Kaufman, andNewmark(197I) havereported 22therapeuticsurgical procedures in33fungal ulcers, including sixinmedical failures. Thesereports prompted us toexamine theculture andhistopathological results inninemedical failures outof53 casesthathavebeentreated during thepast 4iyears;andtoexamine thevisual results inpatients treated withNatamycin, butinwhomtherapeutic