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Liu HY, Chen PY, Chu HS, Chiu YT, Chen YC, Hu FR. Investigating the Influence of Temperature and Supplementation Timing on Antifungal Efficacy in Storage Medium for Corneal Transplantation. Ophthalmol Ther 2024; 13:2151-2161. [PMID: 38831126 PMCID: PMC11246334 DOI: 10.1007/s40123-024-00969-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/13/2024] [Indexed: 06/05/2024] Open
Abstract
INTRODUCTION Although antifungal supplementation reduces the fungal load in the corneal storage medium, consensus is lacking on the influence of dosing and temperature. The study aims to evaluate the impact of eye bank warming protocol and timing of antifungal supplements on efficacy in Optisol-GS and tissue. METHODS Corneoscleral rims contaminated with Candida albicans (C. albicans) were incubated in Optisol-GS, either without antifungal agents or with the addition of amphotericin B or voriconazole at various concentrations (2 ×, 5 ×, 10 ×, and 20 × MIC), at different time points, and under various preservation temperatures (2-8 °C versus 2 h-room temperature exposure). Antifungal efficacy was evaluated by counting viable yeast colonies cultured from Optisol-GS samples. Tissue sterility was determined through direct tissue culture and histological examination of the contaminated rims after a 14-day incubation period. RESULTS Room temperature exposure did not increase colony growth at the same multiple MIC of antifungal agents. Although antifungal addition reduced C. albicans growth in a concentration-dependent manner, yeast growth was still observed in all Optisol-GS samples with a single supplementation after a 14-day incubation. Only groups with additional antifungal supplementation on either day 2 or day 6 showed a 99% or greater reduction of C. albicans growth in Optisol-GS samples and yielded negative results in direct tissue culture. CONCLUSIONS The eye bank warming protocol did not compromise antifungal efficacy. To sustain the required concentration and effectively reduce C. albicans growth in Optisol-GS and contaminated tissue, additional antifungal supplementation on either day 2 or day 6 was necessary during a 2-week preservation period.
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Affiliation(s)
- Hsin-Yu Liu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd, Zhongzheng Dist., Taipei, 10002, Taiwan
- National Eye Bank of Taiwan, Ministry of Health and Welfare, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pao-Yu Chen
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsiao-Sang Chu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd, Zhongzheng Dist., Taipei, 10002, Taiwan
- National Eye Bank of Taiwan, Ministry of Health and Welfare, Taipei, Taiwan
| | - Ya-Ting Chiu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd, Zhongzheng Dist., Taipei, 10002, Taiwan
| | - Yee-Chun Chen
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd, Zhongzheng Dist., Taipei, 10002, Taiwan.
- National Eye Bank of Taiwan, Ministry of Health and Welfare, Taipei, Taiwan.
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Chaurasia S, Dureja R, Roy A, Das S. The expanding roles of eye banks in India: Past, present, and future. Indian J Ophthalmol 2024; 72:S542-S552. [PMID: 38454864 DOI: 10.4103/ijo.ijo_2137_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/07/2023] [Indexed: 03/09/2024] Open
Abstract
This review highlights the evolution in the scope of eye banking activities in India. The roles and responsibilities of the eye banks have expanded to match the requirements and necessities that arose because of advancements in keratoplasty techniques and the need for corneal surgeons. Adoption of different types of corneal preservation solutions and methods of donor cornea preservation was a consequence of the changing and unprecedented times. The growth of eye banking in India has been a commendable journey and has placed the country in an "almost sufficient" category in eye banking and corneal transplantation. There exists a potential to reach the status of cornea surplus country in the future. The rules and laws governing eye banking operations need dynamic amendments based on the trends in keratoplasty, surgical practice patterns, and status of self-sufficiency. Newer technological advances and quality measures must be adopted in donor cornea evaluation and tissue preparation. Research should be integrated as an important component of eye banking, especially in developing novel methods of donor preservation, and evaluating and validating the existing and changing practices of eye banking.
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Affiliation(s)
- Sunita Chaurasia
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Rohit Dureja
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Vishakhapatnam, Andhra Pradesh, India
| | - Arvind Roy
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Sujata Das
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Bhubneshwar, Orissa, India
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Ghenciu LA, Faur AC, Bolintineanu SL, Salavat MC, Maghiari AL. Recent Advances in Diagnosis and Treatment Approaches in Fungal Keratitis: A Narrative Review. Microorganisms 2024; 12:161. [PMID: 38257986 PMCID: PMC10820712 DOI: 10.3390/microorganisms12010161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Fungal keratitis represents a potentially sight-threatening infection associated with poor prognosis, as well as financial burden. Novel diagnostic methods include polymerase-chain-reaction (PCR)-based approaches, metagenomic deep sequences, in vivo confocal microscopy, and antifungal susceptibility testing. The ideal therapeutic approaches and outcomes have been widely discussed in recent times, with early therapy being of the utmost importance for the preservation of visual acuity, minimizing corneal damage and reducing the scar size. However, combination therapy can be more efficacious compared to monotherapy. Understanding the pathogenesis, early diagnosis, and prevention strategies can be of great importance. In this narrative, we discuss the recent progress that may aid our understanding of the diagnosis, treatment, and prevention of mycotic keratitis.
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Affiliation(s)
- Laura Andreea Ghenciu
- Department III Functional Sciences, Victor Babes University of Medicine and Pharmacy, E. Murgu Sq., no. 2, 300041 Timisoara, Romania;
- Department IX Surgery, Discipline of Ophtalmology, Victor Babes University of Medicine and Pharmacy, E. Murgu Sq., no. 2, 300041 Timisoara, Romania;
| | - Alexandra Corina Faur
- Department of Anatomy and Embryology, Victor Babes University of Medicine and Pharmacy, E. Murgu Sq., no. 2, 300041 Timisoara, Romania; (S.L.B.); (A.L.M.)
| | - Sorin Lucian Bolintineanu
- Department of Anatomy and Embryology, Victor Babes University of Medicine and Pharmacy, E. Murgu Sq., no. 2, 300041 Timisoara, Romania; (S.L.B.); (A.L.M.)
| | - Madalina Casiana Salavat
- Department IX Surgery, Discipline of Ophtalmology, Victor Babes University of Medicine and Pharmacy, E. Murgu Sq., no. 2, 300041 Timisoara, Romania;
| | - Anca Laura Maghiari
- Department of Anatomy and Embryology, Victor Babes University of Medicine and Pharmacy, E. Murgu Sq., no. 2, 300041 Timisoara, Romania; (S.L.B.); (A.L.M.)
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Kukutam S, Chaurasia SR, Joseph J, Roy S, Ramachandran C, Kandibanda S. Anti-fungal efficacy of combination of amphotericin B with colistin and gentamicin in McCarey-Kaufman corneal preservation medium. Indian J Ophthalmol 2023; 71:3160-3165. [PMID: 37602602 PMCID: PMC10565927 DOI: 10.4103/ijo.ijo_455_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/26/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To curtail the potential of donor corneal tissue disseminating fungi to the recipient's eye, we evaluated the addition of amphotericin B to McCarey-Kaufman (M-K)-corneal storage medium supplemented with colistin. Methods Amphotericin B was examined for its ability to inhibit the growth of Candida albicans and Aspergillus flavus using a microbroth dilution test and checkerboard assay in combination with only gentamicin and a combination of colistin, gentamicin, and amphotericin B. The safety on epithelium and endothelium was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results The minimal inhibitory concentration of gentamicin was found to be >256 μg/ml against both C. albicans and A. flavus, whereas that of amphotericin B was found to be in a range of 0.25-0.5 and 1-2 μg/ml for C. albicans and A. flavus, respectively. According to the checkerboard assay, 80% (4/5) of C. albicans isolates and 100% (5/5) of A. flavus isolates responded synergistically to the combination of amphotericin B and gentamicin, but only 20% (1/5) of C. albicans isolates showed an additive effect. None of the tested isolates displayed antagonism. The combined effect of the three drugs also did not display any antagonistic effect. Additionally, the MTT assay reveals no toxic effect of the antimicrobials used on corneal epithelial and endothelial cells. Conclusion In vitro experiments demonstrate that amphotericin B is not toxic to either epithelium or endothelium and is a promising additive to the M-K medium supplemented with colistin.
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Affiliation(s)
- Sushmasri Kukutam
- Ramayamma International Eye Bank, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sunita R Chaurasia
- Ramayamma International Eye Bank, LV Prasad Eye Institute, Hyderabad, Telangana, India
- Shantilai Sanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Joveeta Joseph
- Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sanhita Roy
- Prof. Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Charanya Ramachandran
- Prof. Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Srinivas Kandibanda
- Ramayamma International Eye Bank, LV Prasad Eye Institute, Hyderabad, Telangana, India
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