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Recalcitrant fungal tunnel infection treated with intrastromal injection of voriconazole

Vandana Jain1, Nishikant Borse, Debraj Shome

  • 1Department of Cornea and External Diseases, Aditya Jyot Eye Hospital Pvt Ltd, Major Parmeshwaran Road, Wadala, Mumbai, 400031, India. docvandanajain@rediffmail.com

International Ophthalmology
|February 25, 2010
PubMed

Insights

Intrastromal voriconazole injection successfully treated a recalcitrant fungal tunnel infection caused by Aspergillus flavus after cataract surgery. This approach offers a promising alternative to surgery for persistent post-operative infections.

Area of Science:

  • Ophthalmology
  • Mycology

Background:

  • Post-cataract surgery fungal tunnel infections can be challenging to treat.
  • Phacoemulsification with corneal tunnel incision is a common cataract surgery technique.

Observation:

  • A 50-year-old woman developed a recalcitrant fungal tunnel infection caused by Aspergillus flavus one month after phacoemulsification.
  • Despite intensive topical treatment, the corneal and anterior chamber infiltrate enlarged progressively.

Findings:

  • Intrastromal injection of 0.1 ml of 0.05% voriconazole was administered surrounding the corneal infiltrate.
  • Gradual improvement and complete resolution of the fungal infection were observed following the intrastromal injection.

Implications:

  • Intrastromal voriconazole injection is a viable and effective treatment for recalcitrant fungal tunnel infections.
  • This method may be beneficial before considering surgical intervention for such complex cases.
  • Combining topical therapy with judicious intrastromal antifungal administration can improve outcomes.

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