The Efficacy of Topical Application of a New Antifungal Micafungin in the Treatment of Severe Fungal Corneal Ulcer after Keratoplasty

Abstract

Abstract: : Purpose: To report the efficacy of topical application of a new antifungal micafungin (MCFG) in severe fungal corneal ulcers after keratoplasty. Methods: Three patients with fungal corneal ulcer after keratoplasty recalcitrant to conventional antifungal treatment for at least 2 weeks were enrolled. The 0.1% antifungal MCFG eye drops were applied to the patients with fungal corneal ulcer once an hour. After the ulcers healed, the application was reduced to 5 times a day in order to prevent relapse. The patients underwent cultures of scraped cornea and routine ophthalmic examinations including slit–lamp examination, corneal fluoresein–dye staining test. Results: All corneal ulcers healed within 14 days after commencement of application of the 0.1% MCFG eye drops. Yeast–like organisms were detected from cultures of scraped cornea in all eyes. Candida albicans and Candida parapsilosis were identified in 2 cases. There was no relapse of fungal keratitis for at least 6 months. Conclusions: The MCFG eye drops were effective to severe fungal corneal ulcers. Topical MCFG is a new option in the treatment of fungal ulcer refractory to conventional management.

Keywords: cornea: clinical science • fungal disease • transplantation