Abstract

Aim was to assess efficacy of intrastromal voriconazole (ISV) in managing fungal keratitis, not responding to conventional treatment of topical and systemic antifungal drugs. 18 patients non-responding to conventional therapy up to 2 weeks, with smear/ culture positive deep fungal keratitis, were treated with ISV (50µg in 0.1ml). Decrease in size of ulcer and infiltrates was recorded frequently for 3 months or until healed completely. All the patients were successfully treated in terms of corneal healing; but one case did not improve in terms of vision due to preexisting macular edema. Mean number of injections in 17 cured patients was 1.94±0.78. Mean resolution time was 18.50±6.25 days. Mean BCVA improved from 0.94 to 0.25 at 3 months follow-up in all the patients. Targeted Intrastromal Voriconazole injection (50 µg/0.1 mL) appears to be an effective option as an adjunct therapy in cases of recalcitrant deep fungal keratitis reducing the need for tectonic or therapeutic keratoplasty.

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