title: Effectiveness of posaconazole in recalcitrant fungal keratitis resistant to conventional antifungal drugs.
abstract: Purpose. To present the success of posaconazole in two cases with recalcitrant fugal keratitis that were resistant to conventional antifungal drugs. Method. We presented two cases that were treated with posaconazole after the failure of fluconazole or voriconazole, amphotericin B, and natamycin therapy. Case 1 was a 62-year-old man with a history of ocular trauma. He had been using topical fluorometholone and tobramycin. His best corrected visual acuity (BCVA) was hand motion. He had 5.0 × 4.5 mm area of deep corneal ulcer with stromal infiltration. Case 2 was a 14-year-old contact lens user. He had been using topical moxifloxacin, tobramycin, and cyclopentolate. His BCVA was 20/200. He had a 4.0 × 3.0 mm area of pericentral corneal ulcer with deep corneal stromal infiltration and 2 mm hypopyon. Results. Both patients initially received systemic and topical fluconazole or voriconazole and amphotericin B and topical natamycin that were all ineffective. But the response of posaconazole was significant. After posaconazole, progressive improvement was seen in clinical appearance. BCVA improved to 20/100 in case 1 and 20/40 in case 2. Conclusion. Posaconazole might be an effective treatment option for recalcitrant fusarium keratitis and/or endophthalmitis resistant to conventional antifungal drugs.
authors.affiliation: Fatih Sultan Mehmet Education and Research Hospital, Clinic of Ophthalmology, 34752 Istanbul, Turkey.
authors.forename: A
authors.identifier: 0000-0001-8056-0611
authors.initials: A
authors.lastname: Altun
authors.affiliation: Fatih Sultan Mehmet Education and Research Hospital, Clinic of Ophthalmology, 34752 Istanbul, Turkey.
authors.forename: S A
authors.initials: SA
authors.lastname: Kurna
authors.affiliation: Department of Ophthalmology, Istanbul Bilim University, 34710 Istanbul, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Sengor
authors.affiliation: Department of Pediatrics, Yeditepe University, 34752 Istanbul, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Altun
authors.affiliation: Erzurum Region Education and Research Hospital, Clinic of Ophthalmology, 25240 Erzurum, Turkey.
authors.forename: O O
authors.initials: OO
authors.lastname: Olcaysu
authors.affiliation: Fatih Sultan Mehmet Education and Research Hospital, Clinic of Ophthalmology, 34752 Istanbul, Turkey.
authors.forename: S F
authors.initials: SF
authors.lastname: Aki
authors.affiliation: Fatih Sultan Mehmet Education and Research Hospital, Clinic of Ophthalmology, 34752 Istanbul, Turkey.
authors.forename: M H
authors.initials: MH
authors.lastname: Simsek