Comparison of the Performance of Traditional Cold Corneal Storage Media to a New Cold Corneal Storage Media with Antimycotic Tablet

Purpose: To compare the performance of Kerasave and Optisol GS corneal storage media across metrics of donor evaluation and processing.

Material & Methods: Forty paired corneas were swabbed for microbiological testing prior to recovery. Donor decontamination occurred per eye bank SOP, tissue was recovered and placed into a CVC containing Kerasave (Alchimia) or Optisol GS (B&L) at 4°C. Tissue simulated the eye bank process for PK, DSAEK, and DMEK. Endothelial density (ECD), central corneal (or DSAEK graft) thickness (CCT), slit lamp exam (SL), and endothelial cell mortality (ECM) were assessed following incubation. These points in time varied for PK and DMEK/DSAEK groupings. Media was collected at the time of tissue processing for sterility testing, and at time of final evaluation.

Results: Initial swab tests showed 90% and 86% contamination of corneas being stored in Kerasave and Optisol GS respectively, 24% and 19% of which were due to fungal contamination. Kerasave was free of fungi at all points in time, and fungi was detected in one Optisol GS DSAEK media at the end of storage. Initial mean CCT measurements in the Kerasave group were on average 45 ± 3 µm greater than Optisol (p =0.006), but over time this number decreased in the PK group. No statistically significant changes were noted when the Kerasave group was compared to Optisol with respect to ECD or ECM, or when either group was compared to itself over time.

Conclusion: Key metrics of corneas stored in Kerasave and Optisol GS and processed for DSAEK and DMEK were comparable. Over time, and with the exception of DSAEK grafts, the degree of swelling was greater for Optisol GS than Kerasave, while absolute thicknesses were greater in Kerasave.