Treatment Of Keratitis Research Articles

Nanomicelles empower natamycin in treating fungal keratitis: An in vitro, ex vivo and in vivo study

Fungal infections of cornea are important causes of blindness especially in developing nations with tropical climate. However, the challenges associated with current treatments are responsible for poor outcome. Natamycin is the only FDA-approved antifungal drug to treat fungal keratitis, but unfortunately due to its poor water solubility, it is available as suspension. The marketed suspension (5% Natamycin) has rapid precorneal clearance, poor corneal permeability, a higher frequency of administration, and corneal irritation due to undissolved suspended drug particles. In our study, we developed clear and stable natamycin-loaded nanomicelles (1% Natcel) to overcome the above challenges. We demonstrated that 1% Natcel could permeate the cornea better than 5% suspension. The developed 1% Natcel was able to provide sustained release for up to 24 h. Further, it was found to be biocompatible and also improved the mean residence time (MRT) than 5% suspension in tears. Therefore, the developed 1% Natcel could be a potential alternative treatment for fungal keratitis.

A water transfer printing method for contact lenses surface 2D MXene modification to resist bacterial infection and inflammation.

Contact lenses (CLs) are prone to adhesion and invasion by pollutants and pathogenic bacteria, leading to infection and inflammatory diseases. However, the functionalization of CL (biological functions such as anti-fouling, antibacterial, and anti-inflammatory) and maintaining its transparency still face great challenges. In this work, as a member of the MXenes family, vanadium carbide (V2C) is modified onto CL via a water transfer printing method after the formation of a tightly arranged uniform film at the water surface under the action of the Marangoni effect. The coating interface is stable owing to the electrostatic forces. The V2C-modified CL (V2C@CL) maintains optical clarity while providing good biocompatibility, strong antioxidant properties, and anti-inflammatory activities. In vitro antibacterial experiments indicate that V2C@CL shows excellent performance in bacterial anti-adhesion, sterilization, and anti-biofilm formation. Last, V2C@CL displays notable advantages of bacteria elimination and inflammation removal in infectious keratitis treatment.

Efficacy of propolis extract and eye drop solutions to suppress encystation and excystation of Acanthamoeba triangularis WU19001-T4 genotype

Background Propolis is a natural resinous product from a variety of plants and combines it with beeswax and salivary enzymes to create bee glue. Its potentials have been employed in the treatment of many diseases and conditions for centuries. This study, therefore, aims to determine the anti-Acanthamoeba properties of the propolis extract, eye drops coupled to some mechanisms such as inhibition of encystation and excystation. Methods The minimum inhibitory concentrations (MICs) of the most active propolis extract were assessed in trophozoites and cysts of Acanthamoeba triangularis (A. triangularis) at 0.256 and 1 mg/mL, respectively. Results Active eye drops inhibited trophozoites and cysts with a MIC value of 100%. At concentrations lower than their MICs values (1/2–1/16 MIC), propolis and eye drops revealed inhibition of encystation. In addition, at 1/2 MIC, both the propolis extract and eye drops showed potential inhibition of excystation. In combined sets of propolis extract and eye drops, they showed slightly increasing inhibition of encystation and excystation. Surprisingly, the MIC of chlorhexidine decreased when combined with the propolis and eye drops. SEM and TEM images displayed morphological changes in A. triangularis treated with combined sets of propolis extract and eye drops. Conclusion From this study, a new combined eye drop solution with propolis extract was found to be helpful in reducing encystation and excystation in A. triangularis. Therefore, this combination is an alternative for the treatment of eye diseases in early stages along with reducing the entry into the cyst stage of Acanthamoeba. The results of this study revealed new anti-Acanthamoeba inhibitors with promising combined alternative therapeutic potential for the treatment of Acanthamoeba keratitis.

An Overview of Prevalence and Treatment of Mycotic Keratitis in India and other Countries in the Indian Subcontinent

An Overview of Prevalence and Treatment of Mycotic Keratitis in India and other Countries in the Indian Subcontinent

Efficacy of a Novel Antibiotic Drug Combination Toward Multidrug-Resistant Ocular Pathogens.

Antimicrobial resistance is a global health threat, compounded by the reduction in the discovery of new antibiotics. A repurposed drugs-based approach could provide a viable alternative for the treatment of multidrug-resistant (MDR) bacterial infections. In this study, we sought to evaluate the in vitro efficacy of a novel drug combination, polymyxin B/trimethoprim (PT) + rifampin on MDR isolates from patients with bacterial keratitis in India. Forty-three isolates, which included 20 Staphylococcus aureus , 19 Pseudomonas aeruginosa , 3 Pseudomonas stutzeri , and 1 Acinetobacter baumannii , were evaluated for their antibiotic resistance by minimum inhibitory concentration (MIC). Fractional Inhibitory Concentration Index (FICI) testing was performed to measure the antimicrobial impact of PT + rifampin in combination. Among S. aureus isolates, 100% were resistant to at least 1 antibiotic class, 12 (60%) were MDR, and 14 (70%) were classified as methicillin-resistant. Among the gram-negative isolates, >90% were classified as MDR. Fractional Inhibitory Concentration (FIC) testing revealed that PT + rifampin was effective in completely inhibiting growth of all isolates while also displaying additive or synergistic activity in approximately 70% of the strains. Mean FICI values were 0.753 ± 0.311 and 0.791 ± 0.369 for S. aureus and gram-negative isolates, respectively, and a >2-fold reduction in MIC was measured for both PT and rifampin when tested in combination versus alone. Our data demonstrate the ability of PT + rifampin to eliminate all isolates tested, even those conferring MDR, highlighting the promise of this drug combination for the treatment of bacterial keratitis.

Design and development of dual drug-loaded nanofibrous inserts for ophthalmic sustained delivery of AMK and VAN: Pharmacokinetic study in rabbit’s eye

Bacterial corneal keratitis is a damage to the corneal tissue that if not treated, can cause various complications like severe vision loss or even blindness. Combination therapy with two antibiotics which are effective against Gram-positive and Gram-negative bacteria offers sufficient broad-spectrum antibiotic coverage for the treatment of keratitis. Nanofibers can be a potential carrier in dual drug delivery due to their structural characteristics, specific surface area and high porosity. In order to achieve a sustained delivery of amikacin (AMK) and vancomycin (VAN), the current study designed, assessed, and compared nanofibrous inserts utilizing polyvinyl alcohol (PVA) and polycaprolactone (PCL) as biocompatible polymers. Electrospinning method was utilized to prepare two different formulations, PVA-VAN/AMK and PCL/PVA-VAN/AMK, with 351.8 ± 53.59 nm and 383.85 ± 49 nm diameters, respectively. The nanofibers were simply inserted in the cul-de-sac as a noninvasive approach for in vivo studies. The data obtained from the physicochemical and mechanical properties studies confirmed the suitability of the formulations. Antimicrobial investigations showed the antibacterial properties of synthesized nanofibers against Staphylococcus aureus and Pseudomonas aeruginosa. Both in vitro and animal studies demonstrated sustained drug release of the prepared nanofibers for 120 h. Based on the in vivo findings, the prepared nanofibers' AUC0-120 was found to be 20 to 31 times greater than the VAN and AMK solutions. Considering the results, the nanofibrous inserts can be utilized as an effective and safe system in drug delivery.

A Case of Corneal Ulcer Caused by Stenotrophomonas maltophilia in a Healthy Patient

Purpose: To report a case of corneal ulcer caused by <i>Stenotrophomonas maltophilia</i> monomicrobial infection in an otherwise healthy patient, devoid of underlying medical conditions or predisposing factors.Case summary: A 48-year-old male patient, who was normally healthy without a history of systemic disease, eye trauma, and eye surgery, presented with acute left eye pain that had manifested one day prior. Ophthalmic examination revealed conjunctival injection, corneal edema, and localized corneal ulceration in the left eye. Suspecting infectious keratitis, diagnostic procedures including gram staining, bacterial and fungal cultures, and antibiotic susceptibility testing were promptly instituted. Bacterial culture identified <i>S. maltophilia</i>, prompting an eight-week course of topical gatifloxacin therapy. The subsequent clinical course exhibited improvement, with lingering corneal haziness and the restoration of visual acuity to 1.0.Conclusion: The case featuring the single detection of <i>S. maltophilia</i>, known to cause hospital-acquired opportunistic infections, emphasizes the importance of culture and antibiotic susceptibility testing in the treatment of keratitis. Remarkably, in a patient with a normal immune status and in the absence of factors predisposing to <i>S. maltophilia</i> infections, there were no discernible causative factors damaging the ocular surface environment.

Fabrication of nanozyme-thixotropic anionic hydrogel coating with multi-enzyme-mimicking activity for the treatment of fungal keratitis

Fungal keratitis is the primary cause of infectious corneal blindness in China. Currently, early-stage treatment mainly involves the frequent administration of antifungal medications to ensure prolonged corneal contact and maintain effective drug concentration. This approach, however, may lead to harmful side effects and increased antifungal resistance due to the substantial use of antifungal agents. Consequently, the development of advanced antifungal strategies is essential. In the study, we fabricated a multi-enzyme-mimicking nanozyme-thixotropic anionic hydrogel coating (NHC) that incorporated voriconazole and copper-proanthocyanidins (CuPC) nanozyme, by the Schiff base reaction of self-synthesized polyaldehyde oligomer (PAO) with amino functionalized hyaluronic acid (AHA), for the treatment of fungal keratitis. The thixotropic anionic hydrogel significantly boosts the retention time and permeability of voriconazole, allowing a low dose to achieve a high therapeutic concentration. Additionally, the inherent antifungal and peroxidase-like activities of CuPC, coupled with the intrinsic characteristics of anionic hydrogel, further enhance the antifungal efficacy of NHC. Moreover, the NHC assists in corneal wound healing through stimulating cell proliferation by HA derivative as well as scavenging ROS via the catalase-like and superoxide dismutase-like activities of CuPC. The in vitro and in vivo studies have illustrated the safety and effectiveness of NHC, indicating its potential in the treatment of fungal keratitis.

PRACTISE AND USE OF OVER-THE-COUNTER TOPICAL AND TRADITIONAL EYE MEDICINES AND THEIR EFFECTS IN FUNGAL KERATITIS CASES IN TERTIARY TEACHING HOSPITAL IN NORTHERN INDIA

Objective: The study goal is to evaluate the utilization and misuse of over-the-counter topical and traditional eye medications and their associated adverse effects in cases of fungal keratitis (FK) among patients. Methods: The research was conducted in the past 36 months at a tertiary teaching hospital in Northern India. All subjects provided informed consent, and the institutional ethical committee granted ethical approval. The study involved 127 cases of FK, clinically diagnosed and confirmed by a 10% KOH mount. Results: Among the baseline characteristics, 51 (40.18%) of the samples were in a 41–60-year-old age group; 78 (61.42%) were male; 116 (91.34%) were from rural areas; 114 (89.76%) had low socioeconomic status; 108 (85.4%) were illiterate; and 50 (39.37%) were farmers. According to visual acuity ratings, at the time of presentation, 57.48% of the patients had vision up to 1/60. In terms of over-the-counter medication usage, 109 (85.82%) respondents used them for the treatment of keratitis, with 64 (61.46%) using steroid drops. In the case of traditional eye medicines, 18 (14.18%) respondents used them, with 5 (27.11%) using milk and ghee. Conclusion: This study underscores the importance of addressing the misuse of over-the-counter and traditional eye medications in cases of FK and advocating for public health interventions to ensure rational and safe eye medication practices.

Topical Insulin Treatment for Neurotrophic Corneal Ulcer with Persistent Epithelial Defect

Background: Neurotrophic keratitis (NK) is a degenerative corneal disease caused by impairment of corneal sensory innervation. It is characterized by decreased or absent corneal sensation, leading to epithelial breakdown, impairment of healing, and ultimately to the development of corneal ulceration, melting, and perforation. We described a case of neurotrophic ulcer with persistent epithelial defect and its remarkable healing response to insulin eye drop treatment. Case Presentation: A 62-year-old male patient was referred to our hospital for the management of stage III NK in the left eye. The condition started 6 months ago; the patient developed a sudden onset of left eye diminution of vision, red eye, and tearing. The patient sought an ophthalmic consultation and was diagnosed with herpes simplex keratitis. On examination, visual acuity OS was hand motion (HM), severe conjunctival injection, deep corneal vascularization, corneal opacity with stromal infiltration, epithelial defect about 3.5 x 6 mm, stromal thinning, Descemet membrane folds and loss of corneal sensation by cotton wisp test. The patient was treated with topical insulin eye drops for 6 weeks and showed substantial ulcer healing and reepithelization of the epithelial defect. Conclusion: Insulin drops have been shown to substantially promote persistent epithelial defect healing in the case of neurotrophic ulcers. Therefore, topical insulin use can potentially help in the treatment of refractory neurotrophic keratitis. Further studies with large case numbers and long follow-ups should be the main focus of future research.

Self-Implantable Core-Shell Microneedle Patch for Long-Acting Treatment of Keratitis via Programmed Drug Release.

Bacteria-induced keratitis is a major cause of corneal blindness in both developed and developing countries. Instillation of antibiotic eyedrops is the most common management of bacterial keratitis but usually suffers from low bioavailability (i.e., <5%) and frequent administration, due to the existence of corneal epithelial barrier that prevents large and hydrophilic drug molecules from entering the cornea, and the tear film on corneal surface that rapidly washes drug away from the cornea. Here, a self-implantable core-shell microneedle (MN) patch with programmed drug release property to facilitate bacterial keratitis treatment is reported. The pH-responsive antimicrobial nanoparticles (NPs), Ag@ZIF-8, which are capable of producing antibacterial metal ions in the infected cornea and generating oxidative stress in bacteria, are loaded in the dissolvable core, while the anti-angiogenic drug, rapamycin (Rapa), is encapsulated in the biodegradable shell, thereby enabling rapid release of Ag@ZIF-8 NPs and sustained release of Rapa after corneal insertion. Owing to the programmed release feature, one single administration of the core-shell MN patch in a rat model of bacterial keratitis, can achieve satisfactory antimicrobial activity and superior anti-angiogenic and anti-inflammation effects as compared to daily topical eyedrops, indicating a great potential for the infectious keratitis therapy in clinics.

Absence of CD80 reduces HSV-1 replication in the eye and delays reactivation but not latency levels.

Herpes simplex virus-1 (HSV-1) infections are among the most frequent serious viral eye infections in the U.S. and are a major cause of viral-induced blindness. HSV-1 infection is known to induce T cell activation, proliferation, and differentiation that play crucial roles in the development of virus-induced inflammatory lesions, leading to eye disease and causing chronic corneal damage. CD80 is a co-stimulatory molecule and plays a leading role in T cell differentiation. Previous efforts to limit lesion severity by controlling inflammation at the cellular level led us to ask whether mice knocked out for CD80 would show attenuated virus replication following reactivation. By evaluating the effects of CD80 activity on primary and latent infection, we found that in the absence of CD80, virus replication in the eyes and virus reactivation in latent trigeminal ganglia were both significantly reduced. However, latency in latently infected CD80-/- mice did not differ significantly from that in wild-type (WT) control mice. Reduced virus replication in the eyes of CD80-/- mice correlated with significantly expanded CD11c gene expression as compared to WT mice. Taken together, our results indicate that suppression of CD80 could offer significant beneficial therapeutic effects in the treatment of Herpes Stromal Keratitis (HSK).IMPORTANCEOf the many problems associated with recurrent ocular infection, reducing virus reactivation should be a major goal of controlling ocular herpes simplex virus-1 (HSV-1) infection. In this study, we have shown that the absence of CD80 reduces HSV-1 reactivation, which marks the establishment of a previously undescribed mechanism underlying viral immune evasion that could be exploited to better manage HSV infection.

Selective Bowman's layer transplantation in the treatment of neurotrophic corneal ulcers.

The aim of this paper is to present the surgical technique of selective Bowman's layer transplantation as well as the results of the surgery in patients with trophic corneal ulcers. The methodology of the study included three eyes from three patients with neurotrophic corneal ulcers grafting with corneal Bowman's layer. Pre- and postoperative analyses of the anterior segment of the eye were based on optical coherence tomography and slit-lamp assessment. Postoperatively a gradual corneal stroma restoration and fast corneal epithelialization were noticed. Based on our observations, the stiff and firm structure of Bowman's layer is supposed to strengthen the corneal surface and maintain its shape. It acts also as an antipathogen and antitoxin corneal barrier. Application of this acellular corneal layer transplantation to cover trophic corneal ulcers is an interesting, modern and crucial method of neurotrophic keratitis treatment.

Recent Advances in Diagnosis and Treatment Approaches in Fungal Keratitis: A Narrative Review.

Fungal keratitis represents a potentially sight-threatening infection associated with poor prognosis, as well as financial burden. Novel diagnostic methods include polymerase-chain-reaction (PCR)-based approaches, metagenomic deep sequences, in vivo confocal microscopy, and antifungal susceptibility testing. The ideal therapeutic approaches and outcomes have been widely discussed in recent times, with early therapy being of the utmost importance for the preservation of visual acuity, minimizing corneal damage and reducing the scar size. However, combination therapy can be more efficacious compared to monotherapy. Understanding the pathogenesis, early diagnosis, and prevention strategies can be of great importance. In this narrative, we discuss the recent progress that may aid our understanding of the diagnosis, treatment, and prevention of mycotic keratitis.

Ocular bioanalysis of moxifloxacin and ketorolac tromethamine in rabbit lacrimal matrix using liquid chromatography-tandem mass spectrometry.

Aim: The fixed-dose combination of moxifloxacin (MOXI) and ketorolac tromethamine (KTR) is widely used for the treatment of bacterial keratitis. Thus, a new LC-MS/MS method was developed to determine MOXI and KTR in lacrimal fluid. Methods: Bioanalysis was performed using aShimadzu 8050 LC-MS/MS in electrospray ionization-positive mode and the method was validated per US FDA guidelines. Isocratic separation wasperformed with aWaters Symmetry C18 column using methanol and 0.1% formic acid containing deionized water (85:15, v/v). Results & conclusion: An easy, quickand selective method was established and applied to assess the ocular pharmacokinetic profile of a commercially available formulation containing MOXI and KTR. Based on thepharmacokinetic data, this work describes pharmacokinetics-based dosage regimen calculations and their clinical significance.

Debulking corneal biopsy with tectonic amniotic membrane transplantation in refractory clinically presumed fungal keratitis

The treatment of fungal keratitis (FK) is challenging due to the subacute indolent course, and initial misdiagnosis. In this retrospective case series, we highlight both the diagnostic and therapeutic roles of corneal biopsy together with amniotic membrane transplantation (AMT) in patients with refractory clinically presumed FK. Debulking biopsy and tectonic AMT were performed during the initial presentation. Biopsy specimens were sent for KOH smears and cultures. After KOH smears confirmed the presence of fungal elements, topical voriconazole 1% was prescribed for the first 72 h then tailored according to the clinical response and the culture results. The outcome measures were complete resolution of infection and restoration of corneal integrity. Cases associated with culture proven bacterial keratitis were excluded. Twelve cases were included in the study. KOH smears confirmed the presence of fungal growth in all specimens. Cultures grew Aspergillus in 6/12 cases, sensitive to voriconazole (5/6) and amphotericin (3/6); Fusarium (4/12), sensitive to both voriconazole and amphotericin; and no growth in 2/12 cases. Amphotericin 0.15% eye drops were added to the 7 cases with proven sensitivity and to the remaining 2 culture negative cases. Gradual resolution of infection was seen in all cases after 35.6 ± 7.8 days. In FK, a debulking biopsy simultaneously with AMT help decrease the microbial load, suppress the inflammatory process, support the corneal integrity, confirm the presence of fungal pathogen.

Factors Associated With Laboratory Test Negativity Following a Transition in Specimen Collection in Microbial Keratitis Cases

Purpose Negative laboratory results make targeting microbial keratitis treatment difficult. We investigated factors associated with laboratory negativity in patients with microbial keratitis in the context of a transition to a new specimen collection method. Methods Microbial keratitis patients with associated laboratory tests were identified in the electronic health record of a tertiary care facility from August 2012 to April 2022. Patient demographics and laboratory results were obtained. Random sampling of 50% of charts was performed to assess the impact of the ocular history and pretreatment measures. The relationship between probability of negative laboratory results with demographics, ocular history, pretreatment measures, and utilization of a new specimen collection method (i.e. ESwab) was evaluated by multivariable logistic regression. Results Of 3395 microbial keratitis patients identified, 31% (n = 1051) had laboratory tests. Laboratory testing increased over time (slope = 2.5% per year, p < 0.001; 19.6% in 2013 to 42.2% in 2021). Laboratory negative rate increased over time (slope = 2.2% per year, p = 0.022; 48.5% in 2013 to 62.3% in 2021). Almost one-third of patients (31.2%, n = 164) were pretreated with steroids. Over two-thirds of patients were pretreated with antibiotics (69.5%, n = 367). 56.5% (n = 297) of patients were outside referrals. In multivariable regression, patients with corticosteroid pretreatment had lower odds of negative laboratory results (odds ratio [OR] = 0.49, p = 0.001). There were higher odds of negative laboratory results for every additional antibiotic prescribed to a patient prior to presentation (OR = 1.30, p = 0.006) and for specimens collected using ESwabs (OR = 1.69, p = 0.005). Age, prior eye trauma, outside referrals, and contact lens wear were not significantly associated with negative laboratory results. Conclusion More microbial keratitis associated laboratory tests are being taken over time. Over 60% of tests were negative by 2022. Factors associated with negative laboratory test results included pretreatment with antibiotics and specimens collected with the new collection method.

Mucoadhesive Hybrid System of Silk Fibroin Nanoparticles and Thermosensitive In Situ Hydrogel for Amphotericin B Delivery: A Potential Option for Fungal Keratitis Treatment.

The purpose of this work was to investigate the feasibility of a novel ophthalmic formulation of amphotericin B-encapsulated silk fibroin nanoparticles incorporated in situ hydrogel (AmB-FNPs ISG) for fungal keratitis (FK) treatment. AmB-FNPs ISG composites were successfully developed and have shown optimized physicochemical properties for ocular drug delivery. Antifungal effects against Candida albicans and in vitro ocular irritation using corneal epithelial cells were performed to evaluate the efficacy and safety of the composite formulations. The combined system of AmB-FNPs-ISG exhibited effective antifungal activity and showed significantly less toxicity to HCE cells than commercial AmB. In vitro and ex vivo mucoadhesive tests demonstrated that the combination of silk fibroin nanoparticles with in situ hydrogels could enhance the adhesion ability of the particles on the ocular surface for more than 6 h, which would increase the ocular retention time of AmB and reduce the frequency of administration during the treatment. In addition, AmB-FNP-PEG ISG showed good physical and chemical stability under storage condition for 90 days. These findings indicate that AmB-FNP-PEG ISG has a great potential and be used in mucoadhesive AmB eye drops for FK treatment.

Cornea on fire: PACK‐CXL in the treatment of infectious keratitis

Infectious keratitis is a severe eye condition that can cause permanent vision loss if not treated promptly. The current standard of care for this condition involves the use of broad‐spectrum topical antibiotic drops. However, researchers have explored photoactivated chromophore for collagen cross‐linking (PACK‐CXL) as a potential treatment option for infectious keratitis. Studies have shown that PACK‐CXL can improve the healing process in bacterial keratitis and prevent corneal melting caused by bacterial enzymatic degradation.When activated by UV light, riboflavin, the photosensitizer used in PACK‐CXL, induces changes in collagen properties, leading to a hardening and strengthening effect on the corneal stroma. However, individuals with corneal ulcers may experience greater penetration of UV light due to the compromised integrity of the cornea, which could cause endothelial cell loss and impair corneal function.The purpose of this presentation is to provide a summary of the evidence on the comparative effectiveness and safety of PACK‐CXL with or without standard therapy versus standard therapy alone for the treatment of bacterial keratitis. The latest randomized controlled trials (RCTs) will be reviewed, and their findings regarding the efficacy and safety of PACK‐CXL in treating infectious keratitis will be discussed, as well as a comparison with standard antibiotic therapy alone. Ultimately, this talk aims to inform evidence‐based recommendations for the treatment of infectious keratitis and provide clinicians with the most up‐to‐date information to make informed treatment decisions.

Cold plasma treatment for fungal keratitis

Aims/Purpose: Fungal keratitis is serious ocular infection caused by any of the fungi species. It is treated with antifungal medications, in worst scenario with cornea transplantation. The therapy is still challenging due to poor drug penetration into the cornea. Cold plasma, produced by ionization of argon gas, contains especially reactive species but also UV radiation which damage microorganisms. The aim of this study is to determine the effect of cold plasma on human corneal epithelial cells (HCE), corneal tissue and multiple pathogen microorganisms to assess the opportunity of cold plasma treatment for fungal keratitis.Methods: The effect of cold plasma on HCE was analysed by the light microscopy, Live/Dead assay, metabolic activity assay, and immunohistochemistry. Disinfecting potential was analysed by plating prevalent yeasts (Candida albicans, C. krusei, C. parapsilosis, C. glabrata) on agar plates and treated with cold plasma. Plasma treatment of infected human donor corneas with C. albicans was determined by measurement of O.D. of liquid culture.Results: The treatment of HCE by cold plasma led to the change of the morphology, significantly lower viability, metabolic activity and proliferation of the cells. Yeast strains were significantly eradicated completely after 5 min of cold plasma treatment (p ≤ 0.001). Cold plasma therapy of the infected human donor corneas showed the decrease of the infection in all tested time intervals with statistical significance (p ≤ 0.01, p &lt; 0.05 and p ≤ 0.001 respectively for 1, 2 and 5 min treatment).Conclusions: Cold plasma treatment showed negative impact on the culture of HCE. The analysis of its effect on the whole corneal tissue is in progress. On the contrary, a significant reduction of CFU was observed in all examined Candida spp. and significant decrease of infection was determined in infected corneas. Therefore, the cold plasma technology showed a potential to be an effective treatment for fungal keratitis.