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Intracameral and Topical Voriconazole for Fungal Corneal Endoexudates

Mittal, Vikas MS; Mittal, Ruchi MS

doi: 10.1097/ICO.0b013e318233f0a8
Clinical Science

Purpose: To evaluate the role of intracameral and topical voriconazole as treatment for fungal keratitis presenting with endothelial exudates.

Methods: Five eyes of 5 patients with fungal keratitis presenting with endoexudates with or without infiltrates in the corneal stroma were included in the study. Intracameral voriconazole 50 mcg/0.1 mL was given followed by topical voriconazole 1% hourly. Main outcome measure was Resolution of endoexudates and corneal stromal infiltrates.

Results: On presentation, all 5 eyes had endoexudates. Diagnosis of fungal keratitis was based on microbiological analysis of endoexudates (3 eyes) and corneal scrapings (2 eyes). After the intervention, the reduction in the size and density of endoexudates were documented and a complete resolution of the infection was seen in all cases within 3 weeks to 3 months. Two patients experienced burning sensations with topical voriconazole. Best-corrected visual acuity (BCVA) at presentation was hand motions in 3 patients and less than 20/125 in the remaining 2 patients. Final BCVA varied from 20/2000 to 20/40 depending on location of corneal scar.

Conclusion: Intracameral and topical voriconazole may be effective against deep fungal keratitis presenting with endoexudates.

Sanjivni Eye Care, Model Town, Ambala City, Haryana, India

Reprints: Vikas Mittal, MS, Consultant, Cornea and Anterior Segment Services, Sanjivni Eye Care, Model town, Ambala City, Haryana-134002 (e-mail: vikas_mittal@hotmail.com).

Financial interests: None; Conflicts of Interest: None.

Received October 25, 2010

Accepted June 3, 2011

© 2012 Lippincott Williams & Wilkins, Inc.