Investigating the Effectiveness of Intrastromal Fluconazole Injection for Treating Fungal Keratitis; An Interventional Study
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Keywords
Vegetative Trauma, Keratitis, Fungal Infection, Fluconazole
Abstract
To determine the effectiveness of Fluconazole injection in the management of fungal keratitis in patients attending a tertiary eye care hospital Sindh, Pakistan.
Methods: This was an interventional and prospective study with a non-probability convenience sampling method. It was carried out in the Ophthalmology department of Ghulam Muhammad Mahar Medical College (GMMMC) Sukkur, Sindh-Pakistan. The time duration was from January 2023 to January 2024. Ethical approval was taken from the Institutional Review Board (IRB) before the initiation of the study. Sample size drawn was 76. Inclusion criteria were patients diagnosed with fungal keratitis based on microbiological findings, corneal infiltration area should be < 10mm in diameter, history of vegetative trauma, satellite lesions on the cornea, corneal stoma and irrespective of age and gender. Exclusion criteria were other types of keratitis, perforation in the cornea, any stage of endophthalmitis, mature cataract,ocular diseases in combination, involvement of sclera, corneal transplantation and fungal infection overspreading stroma and anterior chamber.
Results: A total of 76 participants were included in this study. The mean age was 53.25±10.56 with range of 30-70 years. Mean duration of vegetative trauma at time of presentation was 10.05±4.34 days. There were 27 (35.53%) male and 49 (64.47%) female. There were 54 (71.05%) patients from rural side.Visual acuity status at the last follow-up of the third month showed improvement in visual acuity was seen in 63 (82.89%) respondents, vision remained stable in 11 (14.47%) however 2 (2.63%) had worsened their vision after intervention. Success rate was found to be 74 (97.36%) patients.
Conclusion: Fluconazole injection observed to be most effective drug to treat fungal keratitis mostly in vegetative trauma.
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Abdul Haleem Mirani
Department of Ophthalmology, Ghulam Muhammad Mahar Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, PV2C+GX7, GMC Road, Sukkur, Sindh 65200, Pakistan.
Tehmina Imdad
Department of Ophthalmology, Ghulam Muhammad Mahar Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, PV2C+GX7, GMC Road, Sukkur, Sindh 65200, Pakistan.
Abdul Sami Mirani
Department of Ophthalmology, Ghulam Muhammad Mahar Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, PV2C+GX7, GMC Road, Sukkur, Sindh 65200, Pakistan.
Imran Ali
Department of Ophthalmology, Ghulam Muhammad Mahar Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, PV2C+GX7, GMC Road, Sukkur, Sindh 65200, Pakistan.
Muhammad Faisal Fahim
Bahria University Health Sciences Campus Karachi, Sailor Street D.H.A Phase-II Cantonment,Karachi 74400, Sindh, Pakistan