{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T20:36:30Z","timestamp":1777581390567,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T00:00:00Z","timestamp":1639699200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Science Research Foundation of Aier Eye Hospital Group","award":["AR1904D1"],"award-info":[{"award-number":["AR1904D1"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the therapeutic effect of incorporating continuous administration of voriconazole in the treatment of recalcitrant fungal keratitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective case study, 5 consecutive patients (5 eyes) with fungal keratitis were treated with a standard protocol after the failing maximal conventional medical treatment. The protocol involved continuous lavage of the ulcer with 1% voriconazole through an irrigator for 2\u2005h, twice a day, combined with local and systemic antifungals. Visual acuity, slit lamp findings of the ulcer, and fungal hyphae density by confocal microscope were documented, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 4 patients, the clinical symptoms and slit lamp examination were significantly improved after only 3 days of treatment. The hyphae were shown to decrease in number and morphologically fragmented in corneal stroma by confocal microscopy. After the infection was controlled, 2 cases required further keratoplasty. In one case, the treatment was deemed ineffective and a conjunctival flap had to be created to help control the infection. In all 5 patients, the best spectacle-corrected visual acuity had improved after treatment. With more than 3 months of follow-up, no recurrence of infection was seen in any cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our treatment protocol demonstrated improvement in the treatment of clinically resistant fungal keratitis. Continuous lavage of voriconazole is easy to be implemented and well-tolerated by patients. Modification of the current protocol should be further explored to optimize the therapeutic effectiveness in future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721211068628","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T05:33:53Z","timestamp":1639719233000},"page":"2688-2694","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Continuous administration of voriconazole enhances therapeutic effect for recalcitrant fungal keratitis"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1329-9390","authenticated-orcid":false,"given":"Weiyan","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"},{"name":"Aier Cornea Institute, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiansen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"},{"name":"Aier Cornea Institute, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zexia","family":"Dou","sequence":"additional","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"},{"name":"Aier Cornea Institute, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dandan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinxin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"},{"name":"Aier School of Ophthalmology, Central South University, Changsha, Hunan, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bowen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"},{"name":"Aier School of Ophthalmology, Central South University, Changsha, Hunan, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingwu","family":"Wang","sequence":"additional","affiliation":[{"name":"Aier Cornea Institute, Beijing, China"},{"name":"NeuVision Medical Institute, Arizona, USA"},{"name":"Department of Ophthalmology and Visual Science, College of Medicine, University of Arizona, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0747-4404","authenticated-orcid":false,"given":"Shaowei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cornea, Beijing Aier Intech Eye Hospital, Beijing, China"},{"name":"Aier Cornea Institute, Beijing, China"},{"name":"Aier School of Ophthalmology, Central South University, Changsha, Hunan, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,12,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.7883\/yoken.JJID.2018.269"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2008.04.019"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12281-013-0163-9"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6700557"},{"key":"e_1_3_3_6_2","unstructured":"Castano G Elnahry AG Mada PK. Fungal Keratitis. 2021 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan Available at: https:\/\/www.statpearls.com\/as\/eyes\/23857\/ (accessed 14 Dec 2021)."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.09.023"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000001128"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000001712"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_378_19"},{"key":"e_1_3_3_11_2","first-page":"1075","article-title":"Ineffectiveness of intrastromal voriconazole for filamentous fungal keratitis","volume":"8","author":"Niki M","year":"2014","unstructured":"Niki M, Eguchi H, Hayashi Y, et al. Ineffectiveness of intrastromal voriconazole for filamentous fungal keratitis. 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