Abstract
Purpose :
Fungal keratitis and endophthalmitis has been reported after keratoplasty and the most probable source of infection is from the donor cornea. Currently available preservative medium does not include any antifungal. The aim of this study is to evaluate the efficacy of antifungals, especially Amphotericin B and Voriconazole, in McCarey and Kaufman (MK) medium.
Methods :
MK medium vials were supplemented with either Voriconazole at 1, 2, 20, 50, 100 μg/mL or Amphotericin B at 0.5, 1,2 10, 20 μg/mL. Fixed concentrations of Candida albicans, Aspergillus flavus and Fusarium keratinoplasticum were added to the set of vials. Efficacy outcomes were calculated as ‘viable fungal colony counts’ determined from samples taken on day- 0, 4, 7, 14 and 30. MK medium without antifungal supplements were used as control.
Results :
In the Voriconazole arm, on day-4, reduction in colony count for Candida albicans (1 μg/mL, 36%; 100 μg/mL, 100%), Aspergillus flavus (1 μg/mL, 53.8%; 100 μg/mL, 80.4%) and Fusarium keratinoplasticum (1 μg/mL, 39.0%; 100 μg/mL, 72.2%) was observed. Similarly, in the Amphotericin B arm, on day-4, reduction in colony count for Candida albicans (0.5 μg/mL; 99.9%; 20 μg/mL, 100%), Aspergillus flavus (0.5 μg/mL, 65.2%; 20 μg/mL, 84.8%) and Fusarium keratinoplasticum (0.5 μg/mL, 90.1%; 20 μg/mL, 100%) was observed. On day-30, >90% reduction in colony count was observed for all fungal specimens at all concentrations of Voriconazole and Amphotericin B.
Conclusions :
Addition of Amphotericin B to MK medium may significantly reduce fungal colony counts. There was a continuous reduction of colony counts at all concentrations for both the antifungals till the end of the study period.
This is a 2020 ARVO Annual Meeting abstract.