To compare the safety and efficacy of intrastromal voriconazole alone and in combination with intracameral voriconazole in intractable cases of fungal keratitis

Background: Mycotic keratitis is a potential sight-threatening infection and leading cause of ocular morbidity worldwide. It inherently difficult to treat due the delayed diagnosis fungistatic nature available topical medications. Aims Objectives: The aim compare safety efficacy intrastromal voriconazole alone in combination with intracameral recalcitrant fungal cases. Materials Methods: A prospective, hospital-based, interventional study was conducted 40 cases involving >50% stromal thickness not showing good response conventional antifungal treatment even after 4 weeks. Cases were randomly divided into two groups: group B 20 each; patients received voriconazole, while given intrastromal+intracameral 50 mg/0.1 mL dose. examined daily for 1 week then every weeks monitor progression. Results: Out A, 14 (70%) got improved, 18 (90%) showed significant improvement weeks, difference statistically (P=0.02). In average number injections 3.65±1.56 15.2±8.79 days, B, 2.65±1.44 13.2±7.768 (P=0.033). Conclusion: Intrastromal cost-effective highly efficacious modality managing keratitis. should be recommended thick hypopyon Aspergillus as causative fungi that do respond treatment.