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M.K. Shah, D.C. Ritterband, R. Yang, S.W. Meskin, J.A. Seedor, A. Bhargava, R.S. Koplin; Will the Fortification of Optisol GS® With Voriconazole Reduce the Fungal Contamination Rate of Corneal Donor Rim Cultures? . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2351.
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To assess the efficacy of voriconazole as an additive to Optisol GS® (gentamicin 100 micrograms/ml and streptomycin 200 micrograms/ml) in reducing fungal corneal donor rim contamination.
302 consecutive donor corneal rims stored in Optisol GS® and used in penetrating keratoplasty were bisected under sterile conditions by the operating surgeon and placed back in the storage medium. Two separate preparations of "fresh" Optisol GS® solution were prepared for each half donor rim. One preparation (Tube A) contained Optisol GS® while the other (Tube B) contained Optisol GS® fortified with 100 micrograms/ml of voriconazole. Tube A and Tube B were refrigerated at 3ºC for 24 hours. The rims were then removed and placed in thioglycolate broth (BBL) and incubated at 37º C for 7 days. Turbidity was assessed daily. If turbidity was noted, gram stain and subculture on sabouraud dextrose agar was performed.
The rate of culture positive donor rims in the Optisol GS® (Tube A) was 14.2% (43/302). The rate of positive cultures in the Optisol GS® with voriconazole (Tube B) was 12.6% (38/302). 38 bacteria grew in both media (P.acnes 11, S. epidermidis 14, S. viridans 6, S. aureus 4, P. aeruginosa 2, Serratia marcesans 1 .Five fungal organisms (C. parapsilosis 2, C. albicans 2, C. famata 1) grew in the standard Optisol GS® media (Tube A). No fungal organisms grew in Optisol GS® with voriconazole (Tube B).
The addition of 100micrograms/ml of voriconazole to Optisol GS® appears to reduce the rate of fungal growth in corneal rims stored in Optisol GS®.
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