AIM: To study the intravitreal injection of voriconazole and liposomal amphotericin B combined with vitrectomy on treatment of fungal endophthalmitis.

METHODS: Selection of 27 cases(54 eyes)with fungal endophthalmitis caused by Aspergillus fumigatus infection from September 2014 to September 2016 in our hospital to accept the treatment were as the research objects. The 27 patients were randomly divided into control group and study group 1, study groups 2, each group of 9 patients. After vitrectomy, drug sensitivity test of three groups, drug testing for liposomal amphotericin B and voriconazole, were taken. After the application of oral voriconazole for three groups of patients with atropine ointment, and daily dressing, patients in study group 1 and 2 received intravitreal injected of voriconazole and liposomal amphotericin B respectively. The degree of corneal opacity, vitreous opacity and visual acuity were observed after operation.

RESULTS: Aspergillus fumigatus were sensitive to amphotericin B and voriconazole. Comparison of corneal opacity: at 1d after operation, the differences between control group with study group 1 and 2 were not significant(P>0.05); the differences on the other time points were significant(P<0.05); the differences between group 1 and 2 at different time were not significant(P>0.05). Comparison of aqueous flare: at 1d after operation, the differences between control group with study group 1 and 2 were not significant(P>0.05); the differences on the other time points were significant(P<0.05); the differences between group 1 and 2 at 1 and 15d after operation were significant(P<0.05), the differences at other time points were not significant(P>0.05). Comparison of vitreous body opacity: except for at 1d after operation, the difference between control group and study group 1 were significant(P<0.05); except for at 1, 4 and 6d after operation, the difference between control group and study group 2 were significant(P<0.05); the differences between study group 1 and 2 were not significant(P>0.05), except for at 6d after operation.

CONCLUSION: Intravitreal injection of voriconazole and liposomal amphotericin B combined with vitrectomy can be an effective treatment for fungal endophthalmitis. Compared with liposomal amphotericin B, voriconazole is better for early and middle stage of fungal endophthalmitis.