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      Evaluation of Intrastromal Injection of Voriconazole as a Therapeutic Adjunctive for the Management of Deep Recalcitrant Fungal Keratitis

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      American Journal of Ophthalmology

      Elsevier BV

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          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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          Author and article information

          Journal
          American Journal of Ophthalmology
          American Journal of Ophthalmology
          Elsevier BV
          00029394
          July 2008
          July 2008
          : 146
          : 1
          : 56-59.e2
          Article
          10.1016/j.ajo.2008.02.023
          18436173
          © 2008

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