Supradescemetic voriconazole injection for Candida parapsilosis keratitis.

Details

Serval ID
serval:BIB_F1B5888C3B3F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Supradescemetic voriconazole injection for Candida parapsilosis keratitis.
Journal
International ophthalmology
Author(s)
Mamas N., Andreanos K., Chatzistefanou K., Petrou P., Brouzas D., Kymionis G., Koutsandrea C., Droutsas K.
ISSN
1573-2630 (Electronic)
ISSN-L
0165-5701
Publication state
Published
Issued date
04/2018
Peer-reviewed
Oui
Volume
38
Number
2
Pages
849-854
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
To describe a technique for intracorneal application of voriconazole into the supradescemetic space in a case of deep recalcitrant Candida parapsilosis keratitis of a penetrating cornea graft.
A deep intracorneal incision reaching the center of the corneal infiltrate was created with a 20-gauge MVR blade. Then, a 27-gauge hydrodissection cannula was inserted deep into the corneal pocket, and 0.1 ml of voriconazole 0.5 mg/ml was injected until a bullous detachment of Descemet membrane (DM) covered 1/3 of the graft's area. DM detachment was documented by anterior segment optical coherence tomography (AS-OCT).
AS-OCT confirmed the creation of a drug depot in the supradescemetic space, which partially regressed during the following hours; 24 h after the injection, a complete reattachment of DM was documented. After 4 weeks, the stromal infiltrate has cleared completely and no signs of recurrence were observed 3 months after injection.
In the present case, the supradescemetic voriconazole injection led to resolution of a deep recalcitrant fungal infiltrate. The herein described technique could be tried in similar cases, where an intrastromal injection is indicated, as it may offer a larger intracorneal drug depot.
Keywords
Aged, 80 and over, Antifungal Agents/administration & dosage, Candida parapsilosis/isolation & purification, Eye Infections, Fungal/drug therapy, Eye Infections, Fungal/microbiology, Humans, Injections, Intraocular, Keratitis/drug therapy, Keratitis/microbiology, Male, Treatment Outcome, Voriconazole/administration & dosage, Candida parapsilosis, Intracorneal injection, Keratitis, Supradescemetic injection, Voriconazole
Pubmed
Web of science
Create date
01/10/2019 13:22
Last modification date
06/10/2019 6:26
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