The Effect of Fortified Antibiotic Therapy on the Visual Outcome of Severe Bacterial Corneal Ulcers

Abstract

Twenty-six patients with bacterial corneal ulcers measuring 4 mm or greater in the smallest diameter were evaluated retrospectively to determine the effect of different modes of antibiotic therapy on the ultimate visual result and medical treatment outcome. Eleven patients were treated only with topical commercially-supplied antibiotic solutions; 15 patients were treated with topical “fortified” antibiotics and/or subconjunctival antibiotic injections. No beneficial effect could be demonstrated in the group receiving the fortified antibiotics and subconjunctival injections. The use of subconjunctival antibiotic injections in the treatment of bacterial corneal ulceration is of questionable value. Although no increased benefit was found with the use of “fortified” antibiotic solutions, their probable enhanced antimicrobial effect and lack of increased epithelial toxicity justify their use in the treatment of bacterial keratitis