To Evaluate The Efficacy Of Monotherapy (Natamycin 5%) And Combination (Natamycin 5% + Voriconazole 1%) Therapy In Management Of Fungal Keratitis, And To Evaluate The Efficacy Of Natasol (1% Soluble Natamycin) In Treating Fungal Keratitis.

To evaluate the efficacy of monotherapy (Natamycin 5%) and combination
(Natamycin 5% + Voriconazole 1%) therapy in management of fungal keratitis, and to
evaluate the efficacy of Natasol (1% soluble Natamycin) in treating fungal keratitis.

Cornea clinic services of a teritiary eye care hospital

Fungal keratitis constitutes a large  proportion of keratitis in many parts of the developing world

Topical Natamycin is the drug of  choice for fungal keratitis; however, has poor ocular penetration

Natasol, a soluble form of Natamycin, has been evaluated in this study

All cases of smear positive or culture proven fungal keratitis were recruited. The
study was a prospective interventional control trial, included ulcers with size < 5mm, depth <
50%. All the patients randomized into three groups; group 1 received Natamycin 5%, group 2
received Natasol (1% soluble Natamycin), group 3 received Natamycin 5% + voriconazole 1
%.

The study included 60 cases of fungal keratitis with a mean age of 46.35 ± 14.5
years and a male – female ratio of 1.8:1. The mean area of the ulcer and infiltrate at
presentation was 15.91±7.64 mm 2 and 17.47±6.4 mm 2 , respectively. Corrected distance visual
acuity at presentation was 1.67±0.29 log MAR that improved to 0.62±0.29 log MAR at 3
months. Aspergillus (38%) was the most common microorganism isolated, followed by
Fusarium (15%). The mean healing time was 43±12 days, with a final scar size of 12±7 mm 2 .
Treatment success rate was 85%.

Topical Natasol (1% soluble Natamycin) can be used as an alternative to
Natamycin in treating mild to moderate fungal keratitis. Monotherapy (Natamycin 5%) is
better than combination therapy (Natamycin 5%+Voriconazole 1%) in treating mild to
moderate fungal keratitis.