METHOD OF TREATING FUNGAL KERATITIS AFTER PENETRATING KERATOPLASTY Russian patent published in 2024 - IPC A61F9/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to ophthalmology, and can be used for treating fungal keratitis after penetrating keratoplasty. That is ensured by staining the cornea with sodium fluorescein. Area of the epithelial defect is determined. Optical coherence tomography is used to determine the total thickness of the cornea in the affected area and the depth of corneal infiltration. With a combination of the corneal infiltration depth of more than 100 mcm and the total corneal thickness in the affected area of more than 300 mcm, the corneal layers affected by mycosis are removed as completely as possible, but to a depth of not more than 1/3 of the corneal thickness, instillation of steroid anti-inflammatory preparations is stopped until complete corneal epithelisation. At first, fluconazole is used in the form of hourly instillations and subconjunctival injections of fluconazole 2% in amount of 0.5 l, performed daily once day for 10 days. On 10^th day, the cornea is repeatedly stained with sodium fluorescein to determine the area of the epithelial defect. Areas of the epithelial defect after treatment with the preparations are compared with the area of the defect before the treatment, and if the difference in the area of the defect before and after treatment is less than 4 mm², fluconazole is substituted with voriconazole in the form of instillations into the lower conjunctival fornix by 1–2 drops of 1% every hour from 11^th day of treatment to clinical recovery. In the absence of clinical improvement on 14^th day of treatment, the instillations are combined with a single intrastromal administration of voriconazole in dose of 0.05–0.1 ml 0.5 mg/ml into an intact cornea using a syringe with a needle and delivered in anterior layers of the stroma to the location of the fungal infection focus.

EFFECT: invention provides personalized treatment of fungal keratitis after penetrating keratoplasty.

1 cl, 3 ex