Table 3

Studies of intrastromal antifungal agents for fungal keratitis

Author, yearNoStudy designControl groupAntifungal agentAntifungal doseOrganismResults
Garcia-Valenzuela,56 20051Case reportNoneAmphotericin0.05 mL of 5 μg/0.1 mLCandidaComplete corneal healing within 3 months.
Prakash,52 20083Interventional case seriesNoneVoriconazole0.05 mL of 50 μg/0.1 mLAspergillus and FusariumComplete resolution within 3 weeks.
Tu,50 20091Case reportNoneVoriconazole0.05 mL of 50 μg/0.1 mLAlternariaComplete resolution within 2 weeks in conjunction with use of topical antifungals.
Jain,49 20101Case reportNoneVoriconazole0.1 mL of 50 μg/0.1 mLAspergillusSlow resolution achieved after 6 weeks.
Neoh,57 20111Case reportNoneCaspofungin0.1 mL of 500 μg/0.1 mLAlternariaSlow resolution in conjunction with topical antifungals and penetrating keratoplasty.
Siatiri,51 20113Interventional case seriesNoneVoriconazole0.1 mL of 50 μg/0.1 mLFusariumReduction of infiltrate noted within 48 h of injection. Topical antifungals used throughout.
Sharma,53 201112Interventional case seriesNoneVoriconazole0.05 mL of 50 μg/0.1 mLMixed speciesResolution of infection achieved in 10 cases. Two cases of corneal perforation requiring penetrating keratoplasty.
Haddad,48 20121Case reportNoneVoriconazole0.07 mL of 50 μg/0.1 mLAcrimoniumSlow resolution in conjunction with continued use of topical and oral antifungals.
Sharma,58 201340Randomised clinical trialYesVoriconazoleUnknown amount 50 μg/0.1 mLMixed speciesSignificantly better final visual acuity in controls (topical natamycin and topical voriconazole) vs controls (topical natamycin and intrastromal voriconazole). No difference in healing time.
Kalaiselvi,55 201525Interventional case seriesNoneVoriconazoleUnknown amount 50 μg/0.1 mLMixed speciesCorneal infection resolved in 72% following injections. Remainder had progression and required therapeutic keratoplasty.
Lekhanont,54 20152Case reportsNoneVoriconazoleUnknown amount 50 μg/0.1 mLLasiodiplodiaInfections resolved within 4 weeks of injections. One patient required a therapeutic keratoplasty.