Evaluation of intrastromal injection of voriconazole as a therapeutic adjunctive for the management of deep recalcitrant fungal keratitis

American Journal of Ophthalmology
Gaurav PrakashRasik B Vajpayee

Abstract

To evaluate the role of intrastromal injection of voriconazole in the management of deep recalcitrant fungal keratitis. Interventional case series. Cornea services at a tertiary care teaching hospital. Three eyes of three patients with deep stromal recalcitrant fungal keratitis not responding to topical antifungal medications. Intervention Procedure: Voriconazole 50 micrograms/0.1 ml was injected circumferentially around the fungal abscess in the corneal stroma as an adjunctive to the topical antifungal therapy. Main outcome measure was a reduction in size of the abscess and resolution of the infection. Before the intracorneal injection, all three eyes had gradually worsening lesions on topical medications. After the intervention, a faster reduction in the size of corneal infiltration was documented and a complete resolution of the ulcers was seen within three weeks in all cases. Targeted delivery of voriconazole by intracorneal injection may be a safe and effective way to treat cases of deep-seated recalcitrant fungal keratitis responding poorly to conventional treatment modalities.

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Citations

Feb 25, 2010·International Ophthalmology·Vandana JainSundaram Natarajan
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