Stability and activity of vancomycin in corneal storage media

Gentamicin is the only antibiotic currently added to commercially available corneal storage media. To reduce the potential for bacterial dissemination from donor corneal tissue to the recipient eye, we evaluated the addition of vancomycin to corneal storage media. When added to Dexsol at a concentration of 200 micrograms/ml, vancomycin levels were maintained, showing a 7% decrease in vancomycin concentration per month, measured < or = 90 days after its addition. Human corneas were stored in gentamicin-free Dexsol (Chiron Ophthalmics, Inc., Irvine, CA, U.S.A.) containing 150 micrograms/ml vancomycin. Corneal tissue levels of vancomycin determined by agar diffusion bioassay were 201, 226, 292 micrograms/ml at 1, 3, and 7 days of storage respectively, suggesting that corneal tissue concentrates vancomycin with time. No differences in endothelial cell count or cell death were seen in corneas stored in Dexsol (containing gentamicin) or Dexsol plus vancomycin when followed for < or = 14 days. Vancomycin added to corneal storage media should reduce the potential for endophthalmitis due to gentamicin-resistant organisms.