Intrastromal Voriconazole and Fungal Keratitis

July’s AJO

Prakash et al. evaluated the role of intrastromal injection of voriconazole in the management of deep recalcitrant fungal keratitis.
Their study included three eyes of three patients with deep stromal recalcitrant fungal keratitis not responding to topical antifungal medications. Patients received voriconazole 50 µg/0.1 ml injected circumferentially around the fungal abscess in the corneal stroma. Before the intracorneal injection, all three eyes had gradually worsening lesions on topical medications.
After the voriconazole injection, a faster reduction in the size of corneal infiltration was documented and a complete resolution of the ulcers was seen within three weeks in all cases. The authors conclude that targeted delivery of voriconazole by intracorneal injection may be an effective method to treat cases of deep-seated recalcitrant fungal keratitis responding poorly to conventional treatment modalities.