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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
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.