Amphotericin B Supplementation of Cold Storage Media to Treat Fungal Contamination of Donor Cornea Transplant Tissue

Authors

Stephen C. Kaufman, MD, PhD, Michelle Rhee, MD

Abstract

Purpose: An increase in the incidence of post-endothelial
keratoplasty fungal infections, most commonly Candida species,
have occurred in the USA. The purpose of this study is to
determine whether the addition of amphotericin b to cold cornea
storage media would reduce or eliminate Candida albicans from
the storage media.

Methods: 80 human donor corneas were placed in individual
vials of Optisol GS (Bausch and Lomb, US). Candida albicans
was added to the treated groups (N=20). The corneas remained
in the storage media for 3 days, which was followed by a 2-hour
warming period (to simulate the tissue processing for DSAEK
or DMEK). This was followed by an additional 1 day of storage.
A fungal assay was then performed. The groups: Group 1) The
control group and had no amphotericin b 0.225 ug/ml added to
the media. Group 2) Amphotericin b 0.225 ug/ml was added to
the storage media when the donor cornea was initially placed in
the media. Group 3) Amphotericin b 0.225 ug/ml was added to
the storage media after the simulated warming period (day 3).
Group 4) Amphotericin b 0.225 ug/ml was added at the initial
time point and after the simulated warming period.

Results: Each treatment group reduced the number of fungal
colony counts by a statistically significant amount, compared
to the control group. Adding amphotericin b at both time points
(group 4) resulted in the greatest reduction in colony counts.
Conclusion: Amphotericin b 0.225 ug/ml was effective at reducing
the number of fungal colony counts in cold cornea storage
media but did not eliminate viable Candida organisms.