Posters

Intra-stromal injection of azithromycin and amikacin for recalcitrant non-tuberculous mycobacterial keratitis

Poster Details

First Author: E.Nche ISRAEL

Co Author(s):    D. Wajnsztajn   A. Solomon   I. Lavy              

Abstract Details

Purpose:

To describe intrastromal injection of antibiotics in the management of non- tuberculous mycobacterial keratitis (NTM).

Setting:

Hadassah - Hebrew University Teaching Hospital, Jerusalem, Israel.

Methods:

A 43-year-old male with sight-threatening, culture positive NTM after corneal trauma who had been treated unsuccessfully with empirical fortified topical antibiotics underwent injections of intrastromal antibiotics. Using a 30G needle, Amikacin 5% and Azithromycin 1% were injected to the corneal stroma from the corneal limbus and deposited around the corneal infiltrate in the deep stroma. This procedure was repeated a month later.

Results:

Progression of the infiltrate was arrested while sparing the visual axis. At 9 months of follow up, the patient’s final corrected Snellen visual acuity for distance was maintained at 0.7 and there was no need for a therapeutic keratoplasty. Intrastromal bleeding occurred after the injections but resolved without sequelae.

Conclusions:

Patients with confirmed NTM resistant to topical treatments can benefit from the early injection of intrastromal antibiotics. This may arrest progression and preserve vision while avoiding the need for a corneal transplantation.

Financial Disclosure:

None