Abstract
Inflammation of the cornea is known as keratitis. Microbial keratitis is a great challenge for the physicians due to its varied presentation, overlapping symptoms and rapid progression. Though bacterial keratitis is the most prevalent in developing countries but recent increasing trend of fungal keratitis carries a significant risk factors and one of the leading causes of vision loss. Early diagnosis and treatment are the cornerstone for its effective control. Purpose: To determine the outcome and efficacy of treatment with topical natamycin and topical voriconazole in different groups. It was a randomised, prospective, comparative, experimental study. The study populations were selected according to inclusion and exclusion criteria after proper evaluation. The study populations were divided into Group A (treated with 1% topical natamycin) and group B (treated 5% topical voriconazole. The patients were followed up subsequently. Data were collected, tabulated in Excel sheet and analyzed in percentage, proportion, t-test and chi square (χ2) test. The statistically significant was considered if p value <0.05. The average age of the study populations was 39.32 ± 14.99 years. Topical voriconazole was found better against primary fungal ulcer than natamycin but not statistically significant (χ2=0.283, p=0.59). The mean healing times of group A and group B were 25.42 ± 4.59 and 24.92 ± 3.99 days respectively. This study concluded that it had male predominance, commonly involved younger people and poor socioeconomic agricultural workers. Both drugs were found effective against primary ulcer but voriconazole was slightly better.
Highlights
Cornea is the major refractive and protective outer layer of eye
Microbial keratitis has long been a challenge for the physicians due to its varied presentation, overlapping symptoms and rapid progression
All fungal keratitis or corneal ulcer patients attended in Outpatient department (OPD) and ER
Summary
Cornea is the major refractive and protective outer layer of eye. Inflammation of the cornea is known as keratitis. 2 This entity is a very common cause of corneal ulcer in developing countries It was epidemic in warmer climates such as India. Increasing incidence of fungal keratitis among the all infectious keratitis has been reported by various centers of India. As many as 50% of fungal cornea ulcer was found in Madurai, South India.[3] Infectious keratitis is a leading cause of mono ocular blindness worldwide. Treatment of fungal keratitis is generally more difficult than that of bacterial ulcers because of its slow pathologic progress, overlapping features, diagnostic difficulty and potential complications thereby resulting severe visual impairment. The triazole derivative, voriconazole is active against both filamentous fungi and Candida species Recent, this drug is used as topical, intracorneal and intracameral preparations in fungal corneal ulcer. Diagnosis and treatment are the corner stone for its effective control
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