Saluja G, Sharma N, Agarwal R, et al. - Researchers conducted this prospective randomized trial to compare the safety and effectiveness of intrastromal voriconazole (IS-VCZ), amphotericin B (IS-AMB) and natamycin (IS-NTM) as an adjunct to topical natamycin (NTM) in cases of recalcitrant fungal keratitis. Participants in the study were 60 patients (60 eyes) with microbiologically proven recalcitrant fungal keratitis (ulcer size > 2 mm, depth > 50% of stroma, and not responding to topical NTM therapy for two weeks). Patients were randomly assigned to one of three groups of 20 eyes, each of which received ISVCZ 50ug/0.1 mL, ISAMB, 5ug/0.1 mL, and ISNTM 10ug/0.1 mL (prepared aseptically in ocular pharmacology). In the management of recalcitrant fungal keratitis, intrastromal injections are a safe and effective adjunct to conventional therapy. ISNTM produced a similar visual outcome with faster healing, whereas ISAMB produced a higher rate of deep vascularization after healing.