Journal d'ophtalmologie clinique et expérimentale
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The Efficacy of Voriconazole Eye Drops Reconstituted in Sterile Water for Injection

Timoleon-Achilleas Vyzantiadis, Asterios Diafas, Anthi-Marina Markantonatou, Evaggelia Zachrou, Angeliki Kakavouti-Doudou, Diamantis Almaliotis and Vasileios Karampatakis

Purpose: To investigate the efficacy of voriconazole 1% eye drops reconstituted in sterile water for injection and stored in the fridge or room conditions and correlate the results to bibliographic data. Methods: Voriconazole powder was reconstituted with water for injection, in order to prepare a 1% solution. The solution was separated in sterile vials stored in the fridge or in the cupboard. Malt extract agar solutions were prepared with the addition of this voriconazole solution to achieve concentrations of 1 μg/ml, 2 μg/ml and 4 μg/ml and the same procedure was repeated after one and after two weeks. Petri plates were inoculated with standardized solutions of Candida albicans, Aspergillus fumigatus, Alternaria alternata, Fusarium solani and Fusarium oxysporum. The fungal growth was compared to the control plates, which contained only malt extract agar without voriconazole. Results: The voriconazole solutions remained effective for more than two weeks (18 days), independently of the storage conditions. The concentration of 1μg/ml was effective against Candida albicans and Aspergillus fumigatus, the 2 μg/ml against Alternaria alternata (and until the 17th day also against Fusarium oxysporum but not on the 18th day) and the 4 μg/ml against Fusarium oxysporum but not against Fusarium solani. Conclusion: The reconstituted with sterile water for injection voriconazole eye drops are effective against various fungi. Fusarium solani was resistant up to the concentration of 4 μg/ml. The susceptibility of the examined fungi varies and thus, considerations should be raised about the combination with other routes of administration in order to achieve the appropriate drug concentrations in the eye. There was no significant difference in the effectiveness of voriconazole solutions in relation to the storage conditions.