Corneal stromal abscessation in two horses treated with intracorneal and subconjunctival injection of 1% voriconazole solution

Abstract

To describe and evaluate intrastromal and subconjunctival injection of voriconazole for the therapy of deep corneal stromal abscess (DSA) in horses. A retrospective clinical study describing the indications for intrastromal and subconjunctival voriconazole injection and the outcomes of this procedure in two eyes of two horses. The two horses in this study failed to respond to medical therapy. Treatment with intracorneal and subconjunctival administration of 1% voriconazole was performed in this study. Treatment with intracorneal and subconjunctival administration of 1% voriconazole was successful in resolving the corneal stromal abscess and the secondary uveitis. Immediate complications from the intracorneal injection occurred, which included corneal stromal lamellar fracture (2/2) and conjunctival hyperemia/chemosis (2/2). Also subconjunctival hemorrhage (1/2) due to the subconjuctival voriconazole injection occurred (2/2). Chronic complications of the intracorneal injection included mild-moderate corneal stromal fibrosis (2/2). This procedure may be an effective technique to treat refractory or relapsing DSA in horses. Intracorneal and subconjunctival voriconazole administration results in a visual and cosmetically acceptable globe. In equine DSA cases, the advantages of this technique compared with other medical and surgical approaches to this disease include shortened anesthesia times, minimal resultant scarring and shorter healing times, and lower cost of therapy.