PMC9022159_01
Slit-lamp examination on the first visit, A - right eye, B - left eye
RomJOphthalmol-66-69-g001.jpg
PMC9022159_01_RomJOphthalmol-66-69-g001.jpg
F1
The anterior segment was normal with incipient lens opacities (Fig. 1A). The anterior chamber had a pseudohypopyon of 2.5 mm (Fig. 1B).
The first surgery, A - corneal debridement, B - intrastromal voriconazole application, C - pseudohypopyon evacuation
RomJOphthalmol-66-69-g002.jpg
PMC9022159_01_RomJOphthalmol-66-69-g002.jpg
F2
It was done using a 15-blade removing layer by layer (Fig. 2A). After the debridement, a 27-gauge needle was inserted under an oblique angle and with the bevel turned down in the area of the clear cornea, around the affected area (Fig. 2B). Paracentesis was afterward performed, pseudohypopyon evacuated, followed by intracameral injection of voriconazole (Fig. 2C).
Intrastromal application technique, A-C - several injection sites surrounding the lesion circularly, forming a barrage around the ulcer area, D - hydration of injection site
RomJOphthalmol-66-69-g003.jpg
PMC9022159_01_RomJOphthalmol-66-69-g003.jpg
F3
Around 0.1 ml of voriconazole was inserted into several injection sites around the lesion in 4-6 divided doses surrounding the lesion circularly, forming a barrage around the ulcer area (Fig. 3A-C). The drug was injected until the injection site was hydrated due to swelling in the middle and deep areas of the cornea, which is a sign of drug penetration and deposit (Fig. 3D).