Corneal Debridement Combined with Intrastromal Voriconazole for Recalcitrant Fungal Keratitis

Figure 1

(a) Fungal ulcer located at the corneal center. The diameter of the ulcer was 5 mm, and it involved midstroma by slit lamp examination. (b) The depth of the ulcer was 320 μm by AS-OCT. (c) Mass hyphae were found by ICVM before treatment. (d) After therapy of topical antifungal and intrastromal voriconazole (50 μg/0.1 ml), the size of infiltration decreased compared with (a), but the ulcer was still obvious. (e) During debridement, the infiltrate and necrotic tissue were removed thoroughly. (f) Trifle hyphae were found by ICVM at 7 days after corneal debridement. (g) The corneal epithelial healed with a little nebula at 14 days after corneal debridement. (h) The residual depth of the cornea was 392 μm by AS-OCT at 14 days after corneal debridement. (i) Corneal scar formed and stroma cell activated with no hyphae by ICVM at 14 days after corneal debridement.

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