DR.PRIYADARSHINI KAMALAKANNAN

DR. NAMRATA SHARMA, DR.PRAFULLA KUMAR MAHARANA, DR. NEHA SANDHU

Abstract

A 65-year-old female who presented with recalcitrant keratitis after Small-incision cataract surgery, with Paecilomyces growth on fungal culture, was initially treated with topical (Voriconazole 1%) and oral antifungal (Tab Voriconazole 200 mg BD), later had to be given multiple intrastromal and intracameral injections of voriconazole (6 times every 3 days). In contrast, a 45-year-old male who presented with keratitis post-trauma, with Paecilomyces growth on fungal culture could be treated with topical and oral antifungal drugs. Repeated Intrastromal voriconazole injections were useful in the resolution of recalcitrant Paecilomyces keratitis in the 65-year-old female patient, whereas early presentation in the 45-year-old male could be managed with topical and oral antifungals. Non-resolving Paecilomyces fungal keratitis can be treated with repeated injections of intrastromal voriconazole before contemplating therapeutic keratoplasty in patients unfit to undergo keratoplasty.