评估伏立康唑基质内注射作为深部顽固性真菌性角膜炎治疗辅助手段的效果。
Evaluation of intrastromal injection of voriconazole as a therapeutic adjunctive for the management of deep recalcitrant fungal keratitis.
作者信息
Prakash Gaurav, Sharma Namrata, Goel Manik, Titiyal Jeewan S, Vajpayee Rasik B
机构信息
Cornea and Refractive Surgery Services, Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Am J Ophthalmol. 2008 Jul;146(1):56-59. doi: 10.1016/j.ajo.2008.02.023. Epub 2008 Apr 24.
PURPOSE
To evaluate the role of intrastromal injection of voriconazole in the management of deep recalcitrant fungal keratitis.
DESIGN
Interventional case series.
SETTING
Cornea services at a tertiary care teaching hospital.
PATIENTS
Three eyes of three patients with deep stromal recalcitrant fungal keratitis not responding to topical antifungal medications. Intervention Procedure: Voriconazole 50 micrograms/0.1 ml was injected circumferentially around the fungal abscess in the corneal stroma as an adjunctive to the topical antifungal therapy.
MAIN OUTCOME MEASURE
Main outcome measure was a reduction in size of the abscess and resolution of the infection.
RESULTS
Before the intracorneal injection, all three eyes had gradually worsening lesions on topical medications. After the intervention, a faster reduction in the size of corneal infiltration was documented and a complete resolution of the ulcers was seen within three weeks in all cases.
CONCLUSION
Targeted delivery of voriconazole by intracorneal injection may be a safe and effective way to treat cases of deep-seated recalcitrant fungal keratitis responding poorly to conventional treatment modalities.
目的
评估基质内注射伏立康唑在治疗深层顽固性真菌性角膜炎中的作用。
设计
干预性病例系列。
地点
一家三级护理教学医院的角膜科。
患者
3例深层基质顽固性真菌性角膜炎患者的3只眼，对局部抗真菌药物治疗无反应。干预措施：在角膜基质内真菌性脓肿周围环形注射50微克/0.1毫升伏立康唑，作为局部抗真菌治疗的辅助手段。
主要观察指标
主要观察指标为脓肿大小的缩小和感染的消退。
结果
在角膜内注射前，所有3只眼使用局部药物治疗时病变均逐渐加重。干预后，记录到角膜浸润大小更快缩小，所有病例在3周内溃疡均完全愈合。
结论
通过角膜内注射靶向递送伏立康唑可能是治疗对传统治疗方式反应不佳的深层顽固性真菌性角膜炎病例的一种安全有效的方法。
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