ESCRS - P105 - TOPICAL VORICONAZOLE AS PRIMARY TREATMENT IN ACANTHAMEBIC KERATITIS - A CASE SERIES

TOPICAL VORICONAZOLE AS PRIMARY TREATMENT IN ACANTHAMEBIC KERATITIS - A CASE SERIES

Published 2023 - 27th ESCRS Winter Meeting

Reference: P105 | Type: Presented Poster & Poster Submission | DOI: 10.82333/0vx7-3d08

Authors: Pallavi Dhawan* 1 , Lional Raj 2

1Ophthalmology ,Rama Medical College ,Kanpur,India, 2Ophthalmology,Dr Agarwal's eye hospital ,Chennai,India

Purpose

To assess the efficacy of topical voriconazole 1percent in acanthamebic keratitis in a case series.

Setting

Tertiary eye hospital

Methods

The study includes  eight contact lens wearers who presented to us with pain,watering,redness and diminution of vision during the year Mar 2019 to   2020.All patients wore contact lens while sleeping.On slit lamp examination,all were suspected of acanthamebic keratitis.Smear and culture were done leading to confirmation of acanthamebic keratitis.Due to unavailability of compounding pharmacy,PHMB ( Polyhexamethylene biguanide ,0.02per and Chlorhexidine 0.02per) preparation was not possible.So,all patients were started on topical voriconazole for 8 weeks and oral fluconazole for 2 weeks.

Results

All patients started showing improvement with in first week of starting of treatment.All patients healed with minimal corneal scarring.None of the patients showed any progression or recurrences.No adverse effects due to drug was noted 

Conclusion

Topical Voriconazole 1 percent can be used as a primary treatment for acanthamebic keratitis if there is unavailability of routine topical medications like PHMB and Chlorhexidine.As this is a small group,we need a larger group study to strengthen our observation.Systemic Fluconazole too must have played role in healing.