Impact of Iontophoresis and PACK-CXL Corneal Concentrations of Antifungals in an In Vivo Model

KALKANCI A., Yesilirmak N., Ozdemir H. B., Unal E. A., Erdogan M., ŞEKER T., ...More

CORNEA, vol.37, no.11, pp.1463-1467, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 37 Issue: 11
  • Publication Date: 2018
  • Doi Number: 10.1097/ico.0000000000001696
  • Journal Name: CORNEA
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1463-1467
  • Keywords: keratitis, voriconazole, iontophoresis, corneal cross-linking, liquid chromatography tandem mass spectrometry, COLLAGEN CROSS-LINKING, TRANSCORNEAL IONTOPHORESIS, AQUEOUS-HUMOR, 1-PERCENT VORICONAZOLE, EYE, KERATITIS, GENTAMICIN, DELIVERY
  • Middle East Technical University Affiliated: Yes


Purpose: To investigate voriconazole (VRZ) penetration and fungal load in the cornea after applying VRZ therapy with various treatment combinations in a fungal keratitis model. Methods: Fifty-four eyes of 27 young albino rabbits were provided for this experimental study. Twelve corneas were inoculated with Candida albicans, 12 corneas were inoculated with Fusarium solani, and 6 eyes were selected as controls. Infected corneas received various treatment combinations including VRZ 1% drop therapy alone, VRZ 1% plus amphotericin B 1% drop combination therapy, iontophoretic VRZ therapy, and VRZ 1% drop therapy after corneal cross-linking. Fungal load was measured by log reduction, and VRZ levels were quantified by liquid chromatography-tandem mass spectrometry. Results: Iontophoresis-assisted VRZ application showed the highest antifungal activity against F. solani keratitis (4-log reduction) and C. albicans keratitis (5-log reduction) compared with other treatment applications. VRZ levels were also found to be the highest in corneas that received iontophoretic VRZ treatment (3.6313 +/- 0.0990 ppb for F.solani keratitis and 1.7001 +/- 0.0065 ppb for C. albicans keratitis) compared with other treatment applications. Conclusions: Iontophoresis seems to provide the highest VRZ concentration and highest antifungal activity in the cornea compared with other treatment applications for C. albicans and F. solani keratitis.