Purpose: Cold corneal storage media available on the market do not contain antimycotics. A new corneal storage medium with an antimycotic tablet (Kerasave, AL.CHI.MI.A. S.r.l.) was developed to prevent fungal contamination of donor corneas intended for transplantation. The aim of this study was to assess the antimycotic activity of the new cold storage medium, Kerasave, and to evaluate the quality of donor corneas preserved in the medium at 4°C for 14 days in comparison with Optisol GS.

Method(s): Kerasave antimycotic activity was determined by in vitro time-kill studies using sterile porcine corneal tissues, contaminated with 10 cfu/ml of C. Albicans (ATCC10231 and clinical isolate). The killing rate of the microorganisms was monitored at 4°C after 5 and 10 days of incubation in Kerasave.
Kerasave performance was assessed on 16 pairs of human corneas not suitable for transplantation, procured and evaluated according to standard procedures of Monza Eye Bank, Italy. One cornea was transferred in Kerasave and the contralateral in Optisol GS. Endothelial cell density (ECD), measured by specular microscopy (Keratoanalyzer, Konan), was evaluated pre-processing, and after 7 and 14 days of storage at 4°C. Endothelial cell morphology and mortality were determined according to Stocker method, and epithelial integrity, and corneal transparency were evaluated using a Slit lamp.

Results: In vitro time-kill studies showed 3.6 log reduction for both Candida strains after 5 days of incubation at 4°C and 4 log reduction was observed for both strains after 10 days of incubation.
Kerasave -and Optisol-GS- treated tissues showed similar ECD, mortality and endothelial morphology after 7 and 14 days of cold storage. Slit lamp analysis showed comparable corneal transparency and epithelial integrity in both groups.

Conclusion: The new cold storage medium with antimycotic tablet, Kerasave, exhibited an excellent antimycotic activity and biocompatibility with donor corneas after corneal storage at 4°C for up to 14 days.

Abstract: Older donor cornea (76-80 yrs old) were stored in Eusol-C and transplanted. None of the recipients developed postoperative endophthalmitis or other inflammatory complications at 3 month post-op and visual acuity was improved in 98% of patients.

Abstract: Eusol-C is a widely used European media for cold corneal storage. In the present study we compared Eusol-C to Optisol-GS. Following transplantation,  corneal endothelial cell densities and corneal thickness were similar between Optisol-preserved corneas and Eusol-preserved corneas.

Abstract: Eusol-C is an effective alternative corneal storage media to the more widely used Optisol-GS. Eusol-C maintained donor cornea viability, similarly to Optisol-GS. New Backlight Corneal Microscopy had significant advantages over traditional slit lamp microscopy for donor corneas evaluation prior to transplant.

Abstract: Eusol-C proved to be an effective alternative corneal storage media,  maintaining donor corneal viability comparable with the more widely used Optisol-GS.