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Repeated Intrastromal Injections of Voriconazole in Combination with Corneal Debridement for Recalcitrant Fungal

I Guber1, C Bergin1, F Majo1

  • 1Department of Ophthalmology, University of Lausanne, Fondation Asile des aveugles, Jules-Gonin Eye Hospital, Lausanne, Switzerland (Chair: Prof. Francine Behar-Cohen).

Klinische Monatsblatter Fur Augenheilkunde
|April 27, 2016
PubMed
Abstract

Insights

Intrastromal voriconazole injections combined with corneal debridement effectively treat deep fungal keratitis. This approach offers a safe and viable option for recalcitrant cases, including Fusarium infections.

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Deep recalcitrant fungal keratitis poses a significant treatment challenge.
  • Conventional therapies may be insufficient for severe fungal eye infections.

Observation:

  • Three patients with culture-proven fungal keratitis (Fusarium, Candida, Pseudallescheria boydii) were treated.
  • Treatment involved repeated intrastromal voriconazole injections (100 mg/ml) alongside corneal debridement.

Findings:

  • A mean of 5 injections were administered every 2-3 days.
  • Repeated corneal debridement was necessary for complete resolution in all cases.
  • The mean age of patients was 65 years.

Implications:

  • Intrastromal voriconazole with debridement is a promising therapeutic strategy.
  • This combined approach demonstrates safety and efficacy in managing difficult fungal keratitis.
  • Effective treatment options are crucial for preventing vision loss from fungal keratitis.

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