Toxicity of voriconazole on corneal endothelial cells in an animal model

To determine the effect of intracamerally injected voriconazole on corneal endothelial cells in rabbit eyes.

Various concentrations of voriconazole (0%, 0.03%, 0.1%, 0.25%, 0.5% and 1%) were injected intracamerally in 36 eyes of 18 rabbits (six eyes for each concentration). Measurements of endothelial cell counts and central corneal thickness were performed at 30, 60, 90 and 120 min after the injection. In each group, five of six corneas were used for the live/dead cell assay; staining with alizarin red and trypan was done. In one cornea from each group, scanning electron microscopy was performed.

There was no significant difference in endothelial cell counts and central corneal thickness among the six groups at any time points. The live/dead cell assay revealed no difference in the mean percentage of dead endothelial cells among the six groups (p=0.504). However, scanning electron microscopy revealed blurring of cell border at voriconazole concentrations ≥ 0.25%, indicating cell wall damage.

Intracameral injection of voriconazole did not induce a significant gross change in rabbit corneal endothelial cells up to a concentration of 1%. However, risk of microstructural damages might exist with a concentration of ≥ 0.25%.