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Antimicrobial efficacy and corneal endothelial toxicity of DexSol corneal storage medium supplemented with vancomycin
F J Garcia-Ferrer1, J S Pepose, P R Murray
1Department of Opthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO 63110.
Abstract:
Despite the presence of gentamicin in corneal storage medium, postoperative endophthalmitis may result from the transmission of bacteria via contaminated corneal tissue. The authors evaluated the antimicrobial activity and endothelial toxicity of vancomycin (10 micrograms/ml) in combination with gentamicin (100 micrograms/ml) in DexSol corneal storage medium. When tested against a panel of common ocular pathogens, vancomycin combined with gentamicin proved more effective than gentamicin alone for inhibiting the growth of Streptococcus pneumoniae at 4 degrees C after 1- and 5-day incubation periods. Ultrastructural and morphometric analyses of paired human corneas stored for 5 days in either DexSol supplemented with vancomycin combined with gentamicin or DexSol with gentamicin alone did not show a significant difference in endothelial toxicity between the two groups. These results suggest that vancomycin combined with gentamicin has superior antimicrobial effect and similar corneal toxicity when compared with media supplemented with gentamicin alone.
Insights
Adding vancomycin to gentamicin in corneal storage media enhances antimicrobial activity against Streptococcus pneumoniae without increasing endothelial toxicity, improving graft preservation for eye banking.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation Science
Background:
- Postoperative endophthalmitis remains a risk despite gentamicin in corneal storage media, often due to bacterial contamination of donor corneas.
- Current corneal storage media may not fully prevent microbial transmission, necessitating improved antimicrobial strategies.
Purpose of the Study:
- To evaluate the antimicrobial efficacy and endothelial toxicity of vancomycin combined with gentamicin in DexSol corneal storage medium.
- To compare the combination therapy against gentamicin alone for preserving corneal tissue.
Main Methods:
- Antimicrobial activity testing of vancomycin (10 µg/ml) plus gentamicin (100 µg/ml) against ocular pathogens at 4°C.
- Ultrastructural and morphometric analysis of human corneas stored for 5 days in supplemented DexSol media.
- Comparison of endothelial cell toxicity between vancomycin-gentamicin and gentamicin-only groups.
Main Results:
- Vancomycin-gentamicin combination demonstrated superior inhibition of Streptococcus pneumoniae growth compared to gentamicin alone after 1- and 5-day incubation.
- No significant difference in endothelial toxicity was observed between corneas stored with the vancomycin-gentamicin combination versus gentamicin alone.
- The combination therapy maintained antimicrobial effectiveness without compromising corneal tissue integrity.
Conclusions:
- Vancomycin combined with gentamicin offers enhanced antimicrobial protection for corneal storage media.
- This combination provides a superior safety profile for corneal transplantation by reducing bacterial contamination risks.
- The findings support the use of vancomycin-gentamicin in corneal storage solutions to improve graft viability and patient outcomes.