Effectiveness of intrastromal voriconazole injection in the management of deep non healing fungal corneal ulcer

Abstract

One of the most difficult conditions to cure is often corneal fungus infections. Due to low stromal penetration, current topical antifungal medications are not very successful in the treatment of fungal keratitis, which makes it challenging to treat cases of deep fungal corneal ulcers. To assess the efficiency of voriconazole intra stromal injection in the treatment of deep fungal corneal ulcers that donot heal. In this prospective interventional study of thirty patients, deep non-healing fungal corneal ulcers were successfully treated by combining intrastromal voriconazole with topical therapy. Voriconazole 50 gm/0.1 ml was injected intrastromally into the corneas of 30 patients with deep stromal non-healing fungal corneal ulcers who had not responded to topical antifungal medication. Patients were monitored for six to ten weeks following the operation. The size of the corneal infiltration was noted to decrease more quickly, and in the majority of cases, ulcers completely disappeared between 6 to 10 weeks. As an additional therapy, intrastromal voriconazole injection may be a safe and efficient strategy to treat cases of deeply seated fungal corneal ulcers that refuse to heal.