Jain Vandana, Borse Nishikant, Shome Debraj, Natarajan Sundaram
Department of Cornea and External Diseases, Aditya Jyot Eye Hospital Pvt Ltd, Major Parmeshwaran Road, Wadala, Mumbai, 400031, India.
Int Ophthalmol. 2010 Dec;30(6):723-5. doi: 10.1007/s10792-010-9354-3. Epub 2010 Feb 24.
We are reporting a case of recalcitrant fungal tunnel infection treated with intrastromal injection of voriconazole. A 50-year-old woman underwent an uneventful phacoemulsification through a temporal corneal tunnel incision for age-related cataract in her right eye. One month post-surgery, she developed tunnel infection. Microbiological investigations revealed Aspergillus flavus as the offending pathogen. Despite intensive medical treatment, the corneal and anterior chamber infiltrate progressively enlarged. At the end of three and a half weeks, 0.1 ml of 0.05% voriconazole was injected intra-stromally surrounding the central end of the corneal infiltrate. On the subsequent follow-ups, a gradual improvement was noted and slowly it resolved completely. Topical therapy along with a judicious use of intrastromal administration of antifungal drugs may be of immense benefit in such cases prior to embarking on the surgical treatment.
我们报告了一例经基质内注射伏立康唑治疗的顽固性真菌性隧道感染病例。一名50岁女性因年龄相关性白内障在右眼经颞侧角膜隧道切口进行了顺利的超声乳化手术。术后1个月，她发生了隧道感染。微生物学检查显示黄曲霉为致病病原体。尽管进行了强化药物治疗，角膜和前房浸润仍逐渐扩大。在三周半时，在角膜浸润中央末端周围基质内注射了0.1 ml 0.05%的伏立康唑。在随后的随访中，观察到病情逐渐改善并最终完全消退。在开始手术治疗之前，局部治疗联合谨慎使用抗真菌药物的基质内给药在此类病例中可能具有巨大益处。
