Preliminary observations of voriconazole treatment of moderate and severe fungal corneal ulcer

Abstract

Objective To investigate the effect of voriconazole in the systemic and local medication treatment of moderate and severe fungal corneal ulcers.Methods The treatments and results of 24 patients (24 eyes)with fungal corneal ulcers were retrospective analyzed.Of 17 cases were with moderate corneal ulcers and 7 with severe corneal ulcers.All patients were treated with intravenous voriconazole,6mg/kg for the first time,4 mg/kg on day 2,once per 12 hours; 1% of the voriconazole eye drops,once per 1 hour; hypopyon was washed out with anterior chamber injection of voriconazole,with local debridement,once per 1 to 2 days.Finally,the conjunctival flap covering surgery or the corneal transplant surgery was chosen based on the condition of patients.Results In 21 of 24 eyes(87.5%)achieved clinical cure,one eye improved and two invalid;1 of the 2 invalid eyes received eye evisceration surgery,the other received a corneal transplant surgery,with no serious adverse drug reactions.Conclusions Voriconazole is a safe,effective medicine in treating fungal corneal ulcers,and it is worthy of clinical application. Key words: Voriconazole; Fungal corneal ulcer; Hypopyon; Treatment