Table 3

Studies of intrastromal antifungal agents for fungal keratitis

Author, year	No	Study design	Control group	Antifungal agent	Antifungal dose	Organism	Results
Garcia-Valenzuela,56 2005	1	Case report	None	Amphotericin	0.05 mL of 5 μg/0.1 mL	Candida	Complete corneal healing within 3 months.
Prakash,52 2008	3	Interventional case series	None	Voriconazole	0.05 mL of 50 μg/0.1 mL	Aspergillus and Fusarium	Complete resolution within 3 weeks.
Tu,50 2009	1	Case report	None	Voriconazole	0.05 mL of 50 μg/0.1 mL	Alternaria	Complete resolution within 2 weeks in conjunction with use of topical antifungals.
Jain,49 2010	1	Case report	None	Voriconazole	0.1 mL of 50 μg/0.1 mL	Aspergillus	Slow resolution achieved after 6 weeks.
Neoh,57 2011	1	Case report	None	Caspofungin	0.1 mL of 500 μg/0.1 mL	Alternaria	Slow resolution in conjunction with topical antifungals and penetrating keratoplasty.
Siatiri,51 2011	3	Interventional case series	None	Voriconazole	0.1 mL of 50 μg/0.1 mL	Fusarium	Reduction of infiltrate noted within 48 h of injection. Topical antifungals used throughout.
Sharma,53 2011	12	Interventional case series	None	Voriconazole	0.05 mL of 50 μg/0.1 mL	Mixed species	Resolution of infection achieved in 10 cases. Two cases of corneal perforation requiring penetrating keratoplasty.
Haddad,48 2012	1	Case report	None	Voriconazole	0.07 mL of 50 μg/0.1 mL	Acrimonium	Slow resolution in conjunction with continued use of topical and oral antifungals.
Sharma,58 2013	40	Randomised clinical trial	Yes	Voriconazole	Unknown amount 50 μg/0.1 mL	Mixed species	Significantly 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 2015	25	Interventional case series	None	Voriconazole	Unknown amount 50 μg/0.1 mL	Mixed species	Corneal infection resolved in 72% following injections. Remainder had progression and required therapeutic keratoplasty.
Lekhanont,54 2015	2	Case reports	None	Voriconazole	Unknown amount 50 μg/0.1 mL	Lasiodiplodia	Infections resolved within 4 weeks of injections. One patient required a therapeutic keratoplasty.