ESCRS - PP06.13 - Antifungal Reservoir In Boston Sight Scleral Contact Lens For The Treatment Of Fungal Keratitis

Antifungal Reservoir In Boston Sight Scleral Contact Lens For The Treatment Of Fungal Keratitis

Published 2023 - 41st Congress of the ESCRS

Reference: PP06.13 | DOI: 10.82333/tfax-3097

Authors: Sushank Ashok Bhalerao* 1 , Vishwa Sanghavi 2 , Pratik Gogri 3 , Prerana Shetty 4

1Cornea, Cataract and Refractive Surgery Department,L V Prasad Eye Institute,Vijayawada, Andhra Pradesh,India;Cornea, Cataract and Refractive Surgery Department,L V Prasad Eye Institute,Vijayawada, Andhra Pradesh,India, 2Cornea,Cataract and Refractive Surgery Department,Nandadeep Eye Hospital,Mulund,Mumbai,India, 3Cornea,Cataract and Refractive Surgery Department,Dr Agarwals Eye Institute,Navi Mumbai, Maharashtra,India, 4Cornea,Cataract and Refractive Surgery Department,L V Prasad Eye Institute,Vijayawada, Andhra Pradesh,India

  • To report the outcomes of using BostonSight Scleral contact lens with an antifungal reservoir as a therapeutic approach for fungal keratitis and to discuss the clinical potential of this treatment modality in future to treat fungal keratitis.

  •  A prospective consecutive case series study 

  • Patients 18 years of age or older diagnosed with fungal keratitis on microbiologic examination of corneal scraping samples during February to July months of 2022  segregated based on the following morphological characteristics: location (central or peripheral), lesser than 5  mm of area, superficial 2/3 of depth, presence of anterior segment inflammation (moderate to severe), and fibrinous exudate and/or compromised visual acuity, were included in the study.
  • Whereas, patients with clinical herpetic keratitis, high risk of corneal perforation (presence of a descemetocele or more than 80% corneal thinning and/or melting clinically observed by slit-lamp examination), allergies to topical antifungals and pregnancy were excluded. 

  • The average age of the patients was 41.66 (Range: 37- 47) with two male and one female subjects.
  • Average size of the ulcer was 2mm (1-3mm).
  • The resolution period for each patient was different. Larger sized ulcers took longer to resolve (>3mm).
  • All three patients had a peripheral infiltrate.
  • Out of the three subjects, one had hypopyon.
  • Average duration of resolution was 28.8 days with a range of 7-34 days.
  • AS-OCT also showed resolution and stromal scarring post lens wear.

  • BostonSight Scleral contact lens with an antifungal reservoir is an effective therapeutic approach for fungal keratitis and could be an alternative in the management of fungal keratitis.
  • This treatment modality could offer a comfortable treatment for the patient, ensuring good impregnation and maintenance of antifungal concentrations during the 24-hour wear periods.