To evaluate the risk factors for treatment failure in fungal keratits.

A total of 109 patients with fungal keratitis, who were diagnosed by clinical findings, smears, and cultures and followed up for at least 2 months, were studied retrospectively. Age, sex, previous history of trauma, systemic diseases, corticosteroid use, previous ocular disease, features of keratitis, causative organism, and treatment results were reviewed. An initial univariate and multivariate logistic regression analysis was performed to identify and select the main prognostic risk factors.

Treatment was successful in 76 patients (69.7%) and failed in 33 patients (30.3%). Fusarium species was isolated in 34 eyes (40.0%), and an ulcer lesion was located in the central area of 54 eyes (49.5%). Multivariate analysis demonstrated that predictors of treatment failure were an ulcer exceeding 10 mm² ( P <0.001) and the presence of previous ocular diseases ( P =0.007).

In patients with fungal keratitis, a large ulcer size and the presence of other ocular diseases were risk factors for treatment failure.