J Korean Ophthalmol Soc.  2013 May;54(5):696-703. 10.3341/jkos.2013.54.5.696.

Clinical Effects of Intracameral Voriconazole Injection in Patients with Fungal Keratitis Refractory to Conventional Treatment

• Jeong SH
• Lee HS
• Cho JK
• Yoon KC

• KMID: 2217033
• DOI: http://doi.org/10.3341/jkos.2013.54.5.696

Abstract

PURPOSE
To evaluate clinical effects of intracameral voriconazole injection in fungal keratitis refractory to conventional therapy.
METHODS
Thirty-eight eyes of 38 patients with fungal keratitis were included in this study. The patients were divided into 3 groups: 13 patients with intracameral voriconazole injection (50 microg/0.1 ml; group A), 11 patients with intracameral amphotericin B injection (10 microg/0.1 ml; group B), and 14 patients with conventional therapy only (group C). Clinical factors including treatment success rate and time to successful treatment were evaluated.
RESULTS
Treatment success was accomplished in 12 eyes in group A (92.3%), 10 eyes in group B (90.9%), and 12 eyes in group C (85.7%). Time to treatment success in group A, B, and C was 36.1 +/- 10.4 days (p = 0.04), 34.2 +/- 7.8 days (p = 0.03), and 49.5 +/- 16.7 days, respectively. Patients who had received intracameral voriconazole injection or amphotericin B showed faster fungal keratitis improvement than patients who received conventional treatment. Time to re-epithelialization and time to disappearance of hypopyon showed a similar clinical course.
CONCLUSIONS
Intracameral voriconazole injection, which has a similar therapeutic effect as intracameral amphotericin B injection in the management of fungal keratitis, can be helpful in the treatment of intractable fungal keratitis.

Keyword

Fungal keratitis; Intracameral; Voriconazole

MeSH Terms

Amphotericin B
Eye
Humans
Keratitis
Pyrimidines
Re-Epithelialization
Time-to-Treatment
Triazoles
Amphotericin B
Pyrimidines
Triazoles

Figure

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  Figure 1. Time to disappearance of hypopyon, healing of epi-thelial defects, and complete healing of patients with treatment success in group A, B, and C. * p < 0.05 compared with group A and C. † p < 0.05 compared with group B and C.

• 

  Figure 2. Comparison of the time to treatment success between patients given intracameral voriconazole injection (group A) and patients given intracameral amphotericin B injection (group B), according to causative organisms. * p < 0.05 com-pared with group A and B.

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