Intrastromal Injection of Fluconazole in Treatment of Fungal Keratitis

Assessment of the Safety and Efficacy of Intrastromal Injection of Fluconazole in Treatment of Fungal Keratitis

This study aimed to evaluate the Safety and the Effectiveness of Intrastromal Injection of Fluconazole in The Treatment of Fungal Keratitis.

Fungal keratitis is one of the most challenging types of infectious keratitis. It now accounts for approximately 50% of infectious corneal diseases, and corneal blindness has become the second leading cause of blindness in developing countries.

The potentially poor prognosis may be due to a delay in diagnosis and / or to limited effective antifungal agents that leads to decrease visual acuity and blindness.

Fluconazole is mainly a fungistatic drug with broad spectrum activity as it is effective against Yeast & Dermatophytes (Candida, Cryptococcus neoformans & Aspergillus species) Fluconazole is stable and a water-soluble small molecule with high bioavailability and low toxicity.

Inclusion Criteria:

• Patients diagnosed both clinically and laboratory as fungal keratitis.
• Fungal cultures should be sensitive to fluconazole.

Exclusion Criteria:

• Thin cornea.
• Decmatocele.
• Necrotic or perforated corneal ulcers.
• Other types of keratitis (bacterial or viral).
• Fungal cultures resistant to fluconazole.
• Patients on immune-suppressants drugs.
• Silicon oil filled eyes.
• Previous ocular surgery e.g keratoplasty.