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Clin Exp Ophthalmol. 2011 Jul;39(5):434-40. doi: 10.1111/j.1442-9071.2010.02473.x. Epub 2011 Jun 28.

Voriconazole versus natamycin as primary treatment in fungal corneal ulcers.

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1
Guru Nanak Eye Centre, New Delhi, India.

Abstract

BACKGROUND:

To evaluate the efficacy of topical 1% voriconazole versus 5% natamycin in treatment of fungal corneal ulcers.

DESIGN:

A prospective, randomized pilot study in a tertiary care hospital.

PARTICIPANTS:

Thirty patients of microbiologically proven fungal keratitis divided randomly in two groups of 15 patients each.

METHODS:

Two groups were treated with either 5% natamycin (group A) or 1% voriconazole (group B) topically as a primary treatment for fungal keratitis. The mean size, depth of infiltrate and LogMAR visual acuity at presentation were comparable in both groups (P > 0.05). Patients were followed up for minimum of 10 weeks or till complete resolution of ulcer, whichever was later. Cultures to identify the causative organisms were performed.

MAIN OUTCOME MEASURE:

Time of resolution of the ulcer.

RESULTS:

Twenty-nine of the total 30 patients showed complete resolution. Average time of resolution and gain in LogMAR visual acuity was 24.3 days and 1.12 in group A and 27.2 days and 0.77 in group B. These were comparable in the two groups (P > 0.05%). Aspergillus spp. (40%) and Curvularia spp. (30.0%) were found to be most common isolates.

CONCLUSION:

Topical 1% voriconazole was found to be safe and effective drug in primary management of fungal keratitis, its efficacy matching conventional natamycin. There was no added advantage of using topical 1% voriconazole over topical natamycin as primary treatment in fungal keratitis.

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