Abstract
Purpose: :
To assess the efficacy and potential endothelial toxicity of voriconazole as an additive to Optisol GS® cornea storage media.
Methods: :
A preparation of Optisol GS® fortified with voriconazole (100 micrograms/ml) was placed in a refrigerator to be used for 14 days (Solution A). Optisol GS® (Solution B) was used as a control. McFarland suspensions of C. albicans, C. glabrata, C. tropicalis, C. zeylanoides, and C. parapsilosis were prepared. Each day (Day #1–14) a new suspension of each organism was inoculated into a sample of Solution A and Solution B. Turbidity was assessed daily. If turbidity was noted, gram stain and subculture on sabouraud dextrose agar was performed. A second experiment using two paired human corneas not suitable for transplantation was performed by endothelial staining with 0.3% trypan blue and 0.2% alizarin red. One buttons were stored in Optisol GS® and one in Optisol GS® fortified with 100 micrograms of voriconazole for 4 days. All endothelial cells that stained (non–viable cells) and non–stained cells (viable cells) were counted and the ratio of nonviable cells to viable cells were counted in five fields and assessed using the Student t test.
Results: :
No growth of fungus was seen until the sample of Solution A (Optisol GS® fortified with voriconazole) drawn on Day #7 .All five fungal isolates were grown on samples drawn from Day #7–14. All samples of Solution B (Optisol GS® ) grew fungal isolates on all days drawn (1–14). In the bioassay, the rate of nonviable cells in the tested cornea and the control was 0.18% and 0.13%, respectively. The difference between the cornea stored in voriconazole fortified Optisol GS® and the cornea stored in Optisol GS® alone was not significant (P >0.05).
Conclusions: :
The addition of voriconazole (100 micrograms/ml) to Optisol GS®does not appear to cause endothelial cytotoxicity. Voriconazole may retain its antifungal properties for up to seven days when added to Optisol GS®. Voriconazole may be a useful additive to Optisol GS® if added at the time of corneal processing.
Keywords: cornea: storage • fungal disease • drug toxicity/drug effects