Fungal
keratitis is one of the major causes of ophthalmic mycosis and is difficult to treat. The range of common
antifungal agents available for fungal
keratitis remains inadequate and is generally associated with poor clinical outcomes.
Voriconazole is a new generation
triazole antifungal agent. Only marketed in systemic formulation and, with broad-spectrum activity and high intraocular penetration,
voriconazole has demonstrated effectiveness against fungal
keratitis. Systemic
voriconazole, however, is not without side effects and is costly.
Voriconazole eye drops have been prepared extemporaneously and used for the treatment of ophthalmic fungal
keratitis. The current article sought to review the literature for evidence related to the effectiveness and safety of topical
voriconazole and its corneal penetration into the aqueous humor of the eye. The
voriconazole eye drops used are typically of 1% concentration, well tolerated by the eye, and are stable. Despite existing evidence to suggest that the
eye drops are effective in the treatment of fungal
keratitis, more studies are needed, especially in relation to using the
eye drops as first-line and stand-alone treatment, preparation of higher concentrations, and optimal dosing frequency.