Modified ulcer debridement versus argon laser photocoagulation as an adjunctive therapy for treatment of fungal keratitis

Abstract

Abstract Background Mycotic keratitis is a disorder due to fungal invasion into the corneal stroma. Early diagnosis and immediate management are critical to avoiding long-term consequences with fungal keratitis as it grows quickly and can cause corneal ulcers and vision loss. Aim To compare the effect of argon laser photocoagulation with tissue debridement as a supportive therapy for treatment of fungal keratitis. Patients and methods In this prospective study, 40 patients with resistant fungal keratitis were evaluated and treated with argon laser and debridement as a supportive therapy in resistant cases.The duration of the study was 12 months with follow-up period of 3 months. Results Of 20 eyes, 18 responded to argon laser with complete epithelial healing occurring in the range of 2–4 weeks, with mean of 47.50 ± 7.96 weeks. On the contrary, 16 of 20 eyes responded to debridement, with complete healing occurring in the range of 3–7 weeks, with a mean of 46.15 ± 7.57 weeks. Two cases needed amniotic membrane graft in the laser group, whereas four cases in the debridement group. Conclusion Argon laser therapy is the most effective supplementary step in the treatment of resistant fungal keratitis. Argon laser therapy is preferred to debridement in the management of resistant fungal corneal ulcer and has a significant effect on reducing corneal scarring and improvement of visual acuity.