Prospective interventional study of intrastromal voriconazole injection in nonhealing fungal keratitis
Background: Fungal keratitis is difficult to manage. The fungi are fungistatic. There are limited drugs available. These drugs do not penetrate the cornea deep layers. Thus, the concentration of these drugs is low where it is required. Objective: The objective of this study was to study the efficacy...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-04-01
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| Series: | MRIMS Journal of Health Sciences |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/mjhs.mjhs_79_23 |
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| Summary: | Background:
Fungal keratitis is difficult to manage. The fungi are fungistatic. There are limited drugs available. These drugs do not penetrate the cornea deep layers. Thus, the concentration of these drugs is low where it is required.
Objective:
The objective of this study was to study the efficacy of intrastromal voriconazole injection in nonhealing fungal keratitis.
Materials and ethods:
Hospital-based prospective interventional study was carried out among 20 cases with fungal keratitis. Detailed clinical evaluation was done. Visual acuity was tested using Snellen chart. Freshly prepared voriconazole in the dose of 50 mg/0.1 mL was given. It was divided into five doses. It was infiltrated near the lesion. Any complication occurring during the intrastromal injection was noted. Patients were followed for 3 months.
Results:
Mean age was 53.2 years. Most cases were of 41–50 years (35%). There were 16 males (80%) and 4 females (20%). Six had diabetes mellitus. Fifty percentage had previous history of trauma with vegetative matter. All patients had deep stromal involvement except 2. At 4 weeks, 16 (80%) improved in the size of stromal infiltrate after 3 doses of intrastromal injection, 1 (5%) did not show any improvement in the size of stromal infiltrate, 1 (5%) showed an increase in the size of stromal infiltrate, and 2 (10%) had perforation and were taken for keratoplasty. Overall, there was an improvement in the visual acuity of the majority of cases.
Conclusion:
Intrastromal voriconazole injection is a safe and effective way to treat nonhealing deep fungal keratitis. |
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| ISSN: | 2321-7006 2321-7294 |