A Case of Fungal Keratitis Treated with Voriconazole

ABSTRACT

PURPOSE: To report drug-resistant fungal keratitis that was treated with voriconazole. CASE SUMMARY: A 31-year-old man was admitted to hospital because of ocular pain, conjunctival injection, and visual weakness 7 days after LASIK surgery. At that time, his vision was counting finger at 30 cm and he presented with corneal epithelial defects, stromal infiltration, and inflammation in the anterior chamber of his eye. He was transferred to our hospital because his infection was resistant to gatifloxacin, tobramycin, amphotericin B, and natamycin eyedrops. At the time of transfer, his vision was counting finger at 30 cm and he presented with corneal epithelial defects, stromal infiltration, and hypopyon. He was treated with topical 2% voriconazole every 2 hours and the lesion improved. However, the hypopyon recurred after 12 days. He was then treated with intracameral voriconazole injection (50 microgram/0.1 cc) and topical 5% voriconazole every hour causing the hypopyon to disappear. His vision improved from counting finger to 20/40 six months after this treatment.