Antimycotic Efficacy and Safety of a New Cold Corneal Storage Medium by Time-Kill and Toxicity Studies

Laura Giurgola, Claudio Gatto, Jean Marie Parel, Darlene Miller, Jana D'Amato Tóthová

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Purpose:To evaluate a new corneal cold storage medium including an antimycotic tablet (Kerasave, AL.CHI.MI.A. S.r.l.).Methods:Kerasave and tryptone soy broth (control) were inoculated with 103 and 105 colony-forming units (CFU)/mL of 6 Candida isolates (Candida albicans [n = 4], Candida tropicalis [n = 1], and Candida glabrata [n = 1]). Minimum inhibitory concentrations (MICs) were determined using amphotericin B Etest strips. Sterile porcine corneas contaminated with 105 CFU/mL of each isolate were incubated in Kerasave and control at 4°C. Growth rate and Log10 reduction at 4°C at different time intervals were determined for liquid samples and tissue homogenates. Kerasave biocompatibility was assessed according to ISO 10993-5 and ISO 10993-10.Results:No C. albicans or C. tropicalis colonies were recovered from Kerasave inoculated with 103 CFU/mL after incubation for 3 days at 4°C. C. glabrata was inhibited but not killed after 3 days at 4°C. Four of the 6 strains contaminated with 105 CFU/mL demonstrated a significant ≥ 3 Log10 reduction in media and tissue homogenates within 5 days as compared to controls (p < 0.01). Amphotericin B MICs ranged from 0.19 to 0.38 g/mL for C. albicans (n = 3) and C. tropicalis (n = 1). C. glabrata showed reduced susceptibility (0.5 g/mL) and 1 C. albicans was resistant to amphotericin B (≥ 1 g/mL). Kerasave was not cytotoxic, irritating, or sensitizing according to the ISO standards.Conclusions:Kerasave showed high antifungal efficacy against susceptible fungal strains at 4°C in the presence and absence of corneal tissue. Resistant strains to amphotericin B were not eliminated by Kerasave. Kerasave is not cytotoxic, irritating, or sensitizing.

Original languageEnglish (US)
Pages (from-to)1314-1321
Number of pages8
Issue number10
StatePublished - Oct 1 2019


  • Candida spp.
  • amphotericin B
  • cornea transplantation
  • eye banking
  • hypothermic storage
  • time-kill assay

ASJC Scopus subject areas

  • Ophthalmology


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