Treatment of six cases of equine corneal stromal abscessation with intracorneal injection of 5% voriconazole solution

Abstract

To describe a reproducible technique for intrastromal injection in the standing horse for treatment of corneal stromal abscessation. A retrospective clinical study addressing the history, treatment, and outcome of six equids (six eyes) that received intrastromal voriconazole injection. Equids having a deep stromal abscess suspected to be of fungal origin were administered intrastromal injection of 5% voriconazole solution under standing sedation in an effort to bring about enhanced resolution of clinical disease. Intracorneal administration of 5% voriconazole solution resulted in resolution of clinical disease, specifically stromal abscessation and secondary uveitis. All animals displayed decreased blepharospasm and no significant complications in the immediate postinjection period. Convalescent periods were subjectively shorter than anticipated with traditional medical therapy. All animals developed mild to moderate stromal fibrosis relative to the initial severity and depth of abscessation. Intrastromal injection of 5% voriconazole solution may provide a safe and effective treatment option for corneal stromal abscessation in horses. In all reported cases, administration of injection early in the treatment period appeared to contribute to rapid resolution of clinical disease without significant complications. The authors present this technique as an alternative to traditional surgical intervention, being more economical, having shorter treatment duration, and potentially resulting in less scar formation.