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. 2015 Apr 9;2015(4):CD004241. doi: 10.1002/14651858.CD004241.pub4

Parchand 2012.

Methods Parallel group randomised controlled trial
1 eye per patient, unclear how eye selected
Date conducted: not reported
Participants Setting: Chandigarh, India
Participants: 45, age and sex not reported
Inclusion criteria: ulcer with epithelial defect more than 5 mm in the greatest dimension, infiltrates involving more than two thirds depth of corneal thickness, proven fungal corneal ulcer either on 10% potassium hydroxide west mount/Calcoflour white stain or growth of fungi on Sabouraud's dextrose agar, older than 18 years, willingness to be an inpatient and take part in follow‐up
Exclusion criteria: perforated cornea or impending perforation, sclera involvement, total corneal involvement, endophthalmitis, acanthamoeba keratitis, evidence of bacterial infection or herpetic keratitis, bilateral ulcers, previous ocular surgery, pregnancy or breast‐feeding, known allergy to medication, no light perception, failed to attend for follow‐up at 3 months.
Interventions
  • Oral and topical voriconazole 1% (N = 15)

  • Oral voriconazole and topical natamycin 5% (N = 15)

  • Oral itraconazole and topical natamycin (N = 15)


Oral voriconazole was given in tablet form 400 mg twice a day on day 1 followed by 200 mg twice a day and continued until the resolution of the infiltrates. Topical voriconazole and natamycin were given every hour while awake for 1 week, then every 2 hours while awake until healing of the epithelial defect and then gradual tapering off.
Outcomes
  • Time to disappearance of the hypopyon (days)

  • Time to resolution of the infiltrate (days)

  • Time to closure of the epithelial defect (days)

  • Final logMAR visual acuity

  • Adverse effects: cataract, perforation, glaucoma, endophthalmitis, phthisis bulbi


Follow‐up: 3 months
Notes Funding sources: not reported
Conflict of interest: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not reported
Allocation concealment (selection bias) Unclear risk Not reported
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Not reported
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Not reported
Incomplete outcome data (attrition bias) 
 All outcomes High risk People who did not attend at 3 months were excluded from the study
Selective reporting (reporting bias) Unclear risk No access to protocol