FP384 : Intra-stromal voriconazole in refractory keratomycosis: Tertiary eye centre experience

Dr.Amit Raj, R12161

Aim: To report the result of intra-stromal voriconazole in recalcitrant keratomycosis

Method: Seven cases of refractory deep fungal keratitis with atleast two weeks of topical 5% natamycin and/or 1 % voriconazole and oral antifungal were included. Intra-stromal voriconazole reconstituted to 50 microns / 0.1 ml was injected circumferentially into the mid-stroma in close proximity to the ulcer margins.

Result : Marked reduction in the size of infiltrate was noted after two intra-stromal voriconazole injection in four patients, while one was remain static. Two cases deteriorated leading to therapeutic penetrating keratoplasty.

Conclusion: Intra-stromal voriconazole may act as adjunctive treatment in refractory keratomycosis as the direct deposition of drug into deeper stroma results into higher therapeutic concentrations into ulcer; thus obviating the need for therapeutic penetrating keratoplasty.