Randomized trial for fungal corneal ulcer- A comparison of outcome between two regimes of medical treatment with topical natamycin and topical voriconazole in a tertiary care Centre

Kumaresh Chandra Sarkar, Tridib Ranjan Naskar, Shashwat Bhattacharyya, Piyali Sarkar, Mukul Chandra Biswas


Background: Inflammation of the cornea is known as keratitis. Microbial keratitis is a great challenge for the physicians due to its varied presentation, overlapping symptoms and rapid progression. Though bacterial keratitis is the most prevalent in developing countries but recent increasing trend of fungal keratitis carries a significant risk factors and one of the leading causes of vision loss. Early diagnosis and treatment are the cornerstone for its effective control. Purpose: To determine the outcome and efficacy of treatment with topical natamycin and topical voriconazole in different groups.
Materials and Methods: It was a randomised, prospective, comparative, experimental study. The study populations were selected according to inclusion and exclusion criteria after proper evaluation. The study populations were divided into Group A (treated with 1% topical natamycin) and group B (treated 5% topical voriconazole. The patients were followed up subsequently. Data were collected, tabulated in Excel sheet and analyzed in percentage, proportion, t-test and chi square (2) test. The statistically significant was considered if p value <0.05.
Result: The average age of the study populations was 39.32 14.99 years. Topical voriconazole was found better against primary fungal ulcer than natamycin but not statistically significant (2=0.283, p=0.59). The mean healing times of group A and group B were 25.42 4.59 and 24.92 3.99 days respectively.
Conclusions: This study concluded that it had male predominance, commonly involved younger people and poor socioeconomic agricultural workers. Both drugs were found effective against primary ulcer but voriconazole was slightly better.

Keywords: Corneal ulcer, Fungal keratitis, Natamycin.

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