Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Jun;261(6):1639-1649.
doi: 10.1007/s00417-022-05969-z. Epub 2023 Jan 16.

Continuous voriconazole lavage in managing moderate and severe fungal keratitis: a randomized controlled trial

Yujia Gong  1   2 , Liwei Zhang  1   2 , Shaohua Liu  1   2 , Hongyan Zhang  1   2 , Li Peng  1   2 , Haoyu Li  1   2 , Shirui Dai  1   2 , Baihua Chen  3   4
Affiliations
Randomized Controlled Trial

Continuous voriconazole lavage in managing moderate and severe fungal keratitis: a randomized controlled trial

Yujia Gong et al. Graefes Arch Clin Exp Ophthalmol. 2023 Jun.

Abstract

Purpose: To assess the effectiveness and safety of continuous lavage with 1% voriconazole (CL) for moderate and severe fungal keratitis.

Methods: Thirty-one patients were randomized to receive topical eye drops either alone (T) or combined with continuous 1% voriconazole lavage (CL-T). The primary outcome was the cure rate at 3 months. The secondary outcomes were the 6-day efficacy, 3-day infiltration size and depth, hypopyon height, central corneal thickness (CCT), epithelial defect size, and subject feelings and clinical signs assessment scores.

Results: At 3 months, the cure rate was comparable between the groups in patients with moderate fungal keratitis (66.7% vs. 62.5%, P = 0.60). However, among severe cases, 4 cases (44.4%) in the CL-T group healed successfully, while none in the T group; this difference was not significant (P = 0.08), although it was very close to 0.05. This may be related to the small sample size. After 6 days, the percentage of patients with "worsened" ulcers in the CL-T group was lower than that in the T group (0% vs. 31%, P = 0.043). The infiltration size, infiltration depth, and hypopyon height in the CL-T group were smaller than those in the T group after 3 days (all P < 0.05). There was no difference in CCT, epithelial defect size, subject feelings scores, or clinical signs scores between groups.

Conclusion: These outcomes suggest that CL is an effective and safe adjuvant method for controlling the progression of moderate and severe fungal keratitis.

Trial registration number: ChiCTR2100050565.

Keywords: Continuous lavage; Effectiveness; Fungal keratitis; Safety.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Austin A, Lietman T, Rose-Nussbaumer J (2017) Update on the management of infectious keratitis. Ophthalmol 124(11):1678–1689. https://doi.org/10.1016/j.ophtha.2017.05.012 - DOI
    1. Lalitha P, Prajna NV, Kabra A et al (2006) Risk factors for treatment outcome in fungal keratitis. Ophthalmol 113(4):526–530. https://doi.org/10.1016/j.ophtha.2005.10.063 - DOI
    1. Prajna NV, Krishnan T, Mascarenhas J et al (2013) The mycotic ulcer treatment trial: a randomized trial comparing natamycin vs voriconazole. JAMA Ophthalmol 131(4):422–429. https://doi.org/10.1001/jamaophthalmol.2013.1497 - DOI - PubMed - PMC
    1. Prajna NV, Krishnan T, Rajaraman R et al (2016) Effect of oral voriconazole on fungal keratitis in the Mycotic Ulcer Treatment Trial II (MUTT II): a randomized clinical trial. JAMA Ophthalmol 134(12):1365–1372. https://doi.org/10.1001/jamaophthalmol.2016.4096 - DOI - PubMed - PMC
    1. Narayana S, Krishnan T, Ramakrishnan S et al (2019) Mycotic antimicrobial localized injection: a randomized clinical trial evaluating intrastromal injection of voriconazole. Ophthalmol 126(8):1084–1089. https://doi.org/10.1016/j.ophtha.2019.03.020 - DOI

Publication types

MeSH terms

LinkOut - more resources