June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Antifungal efficacy of Amphotericin-B and Povidone-Iodine (Betadine) addition to commercial corneal storage media
Author Affiliations & Notes
  • Malcolm Kates
    Ophthalmology, University of Florida College of Medicine, Gainesville, Florida, United States
  • Vektra Casler
    Pathology, University of Florida, Gainesville, Florida, United States
  • Ahmaida Zeglam
    Ophthalmology, University of Florida College of Medicine, Gainesville, Florida, United States
  • Jade Gieseke Guevara
    Ophthalmology, University of Florida College of Medicine, Gainesville, Florida, United States
  • Matthew Gray
    Ophthalmology, University of Florida College of Medicine, Gainesville, Florida, United States
  • Ankit Shah
    Ophthalmology, University of Florida College of Medicine, Gainesville, Florida, United States
  • Sonal Tuli
    Ophthalmology, University of Florida College of Medicine, Gainesville, Florida, United States
  • Mark Gorovoy
    Lions Eye Institute for Transplant and Research, Tampa, Florida, United States
  • Eric Abdullayev
    Lions Eye Institute for Transplant and Research, Tampa, Florida, United States
  • Footnotes
    Commercial Relationships   Malcolm Kates, None; Vektra Casler, None; Ahmaida Zeglam, None; Jade Guevara, None; Matthew Gray, None; Ankit Shah, None; Sonal Tuli, None; Mark Gorovoy, None; Eric Abdullayev, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 420. doi:
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      Malcolm Kates, Vektra Casler, Ahmaida Zeglam, Jade Gieseke Guevara, Matthew Gray, Ankit Shah, Sonal Tuli, Mark Gorovoy, Eric Abdullayev; Antifungal efficacy of Amphotericin-B and Povidone-Iodine (Betadine) addition to commercial corneal storage media. Invest. Ophthalmol. Vis. Sci. 2020;61(7):420.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Fungal keratitis rates following keratoplasty in the United States are increasing, possibly due to the lack of routine antifungal coverage in commercially available corneal storage media. In this basic microbiology study, we compared the relative efficacy of three antifungal preparations of Amphotericin-B and Betadine in commercial corneal storage media as antifungal prophylaxis for stored human corneas.

Methods : Thirty donor corneas deemed unsuitable for therapeutic transplant, donated by the Lions Eye Institute for Transplant and Research, were bathed in a suspension of Candida albicans. They were then split into three experimental arms: Kerasave media with dissolved Amphotericin-B (2.5 mcg/mL), Optisol-GS with compounded Amphotericin-B (2.5mcg/mL), and Optisol-GS with increasing concentrations of Povidone-iodone (0.25%, 0.50%, 0.75%, 1.00%). Following thermal equilibration, each cornea was swabbed, inoculated onto Sabouraud agar, and returned to its original media. Plates were then incubated, swabbed, and re-plated at 2, 4, 6, 8, 10, and 12 days to assess for C. albicans growth. Statistical analysis of colony counts was done via t-test for all days measured.

Results : Fungal growth on donor corneas (compared to untreated storage media alone, p<0.05) was significantly reduced on Day 2 by 92% in Povidone-iodine concentrations of 0.75% and 1.00%, 82% in Kerasave with dissolved Amphotericin-B (2.5mcg/mL), and 80% in Optisol-GS with compounded Amphotericin-B (2.5mcg/mL). Povidone-iodine concentrations of 0.50% and 0.25% reduce 71% of the growth of C. albicans in Optisol-GS corneal storage media (p=0.4675 and 0.7675, respectively).

Conclusions : Kerasave with dissolved Amphotericin-B, Optisol-GS with compounded Amphotericin-B, and povidone-iodine concentrations of 0.75% and 1.00% are potential antifungal prophylaxis options to reduce fungal growth in preserved corneas. Lower concentrations of Povidone-iodine provide less efficient antifungal coverage. While Kerasave is still undergoing FDA-approval, compounded Amphotericin-B and PpPovidone-iodine are readily available antifungal additives that could be added to existing Optisol-GS solutions with support from groups such as the Eye Bank Association of America (EBAA).

This is a 2020 ARVO Annual Meeting abstract.

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