EFFICACY OF TOPICAL VORICONAZOLE 1 % AS COMPARED TO TOPICAL NATAMYCIN 5% IN THE TREATMENT OF FUNGAL KERATITIS

Abstract

Objective: To compare the efficacy of topical Voriconazole 1% with topical Natamycin 5% in the treatment of fungal keratitis in terms of visual acuity, ulcer scar size, and pain perception.

Study Design: Prospective cross-sectional comparative study.

Study Setting: This study was conducted at the Department of Ophthalmology at Madina Teaching Hospital, Faisalabad

Study Duration: Seven Months (Nov 24 to May‘25).

Methodology: A total of 120 patients diagnosed with fungal keratitis were enrolled and divided into two groups (60 each). Group A received topical Voriconazole 1%, while Group B received topical Natamycin 5%. Patients were evaluated at baseline, 1 month, and 3 months for best corrected visual acuity (BCVA), ulcer scar size, and pain perception. Data were analyzed using SPSS version 25. Independent sample t-test and two-way ANOVA for repeated measures were applied, with p ≤ 0.05 considered statistically significant.

Results: Topical Voriconazole showed significantly better improvement in BCVA compared to Natamycin at 1 and 3 months (p<0.001). Ulcer scar size reduction was greater in Group A (from 5.035±0.460 mm to 2.990±0.310 mm) compared to Group B (from 5.051±0.450 mm to 3.518±0.121 mm), with statistically significant differences (p<0.001). Pain perception scores also improved significantly in both groups, with better outcomes in the Voriconazole group (p<0.001). Ulcer healing was observed in 90% of patients in Group A versus 76.7% in Group B (p=0.042).

Conclusion: Topical Voriconazole 1% is more effective than topical Natamycin 5% in improving visual acuity, reducing ulcer scar size, and alleviating pain in patients with fungal keratitis. It may serve as a superior therapeutic option, particularly in cases requiring enhanced drug penetration and clinical response