Cold Storage Media versus Optisol-GS in the Preservation of Corneal Quality for Keratoplasty: A Systematic Review

Abstract

Optisol-GS is the most widely used pharmaceutical composition to preserve corneas for transplantation. This systematic review investigated the effects of different cold corneal storage media (CCSM) compared with Optisol-GS on the quality of stored corneas. The literature was searched throughout May 2022 on six databases and grey literature. Studies including corneas (population) exposed to distinct cold storage media (exposure) and Optisol-GS (comparison) that reported qualitative and/or quantitative parameters of cornea quality (outcome) were included. Methodological quality was assessed using ToxRTool. From 4520 identified studies, fourteen were included according to the eligibility criteria, comprising 769 evaluated cornea samples comparing Optisol-GS with commercial and noncommercial media. All studies showed good methodological quality. Experimental times ranged from 1–28 days, mainly using 4 °C as the preservation temperature. Viable endothelial cell density (ECD) and endothelial cell morphology (EC) were the most assessed parameters. ECD results for Cornisol were higher than Optisol-GS in 10 days (p = 0.049) and favored Cornea ColdTM up to 4 weeks (p < 0.05), which also showed better qualitative results. While the standardization of test protocols could improve comparisons, evidence indicates that most CCSM present similar performances on cornea preservation for transplantation at seven days, while some formulations may increase preservation at extended times.

Eusol-C as Corneal Cold Storage Solution: Early Clinical Outcomes of Keratoplasty

“…8 The presence of 2 mM glutamine as a supplement in the Eusol-C has been proposed to act as a compensating factor for the absence of the additives that are otherwise present in Optisol-GS. 8,9 Eusol-C has been shown to be comparable to Optisol-GS as a cold storage solution for up to 7 days, as shown by the analysis of the donor grafts' endothelial health, stromal edema, and Descemet folding. 10 Camposampiero et al 11 demonstrated that ECD preservation of the donor grafts stored in Eusol-C for up to 2 days was found to be similar to that of donor grafts preserved in Optisol-GS.…”

“…Eusol-C contains gentamicin sulfate and dextran-components that are also present in Optisol-GS. A noteworthy difference between the 2 solutions is the absence of streptomycin sulfate, ascorbic acid, and chondroitin sulfate in Eusol-C. 8 In addition, Optisol-GS also contains nonessential amino acids, purines, and lipid components with antioxidant action. These additives, along with an increased concentration of chondroitin sulfate, were believed to contribute to the preservation and reduction of the rate of vacuolization of endothelial cells.…”

“…These additives, along with an increased concentration of chondroitin sulfate, were believed to contribute to the preservation and reduction of the rate of vacuolization of endothelial cells. 8 The presence of 2 mM glutamine as a supplement in the Eusol-C has been proposed to act as a compensating factor for the absence of the additives that are otherwise present in Optisol-GS. 8,9 Eusol-C has been shown to be comparable to Optisol-GS as a cold storage solution for up to 7 days, as shown by the analysis of the donor grafts' endothelial health, stromal edema, and Descemet folding.…”

“…These additives, along with an increased concentration of chondroitin sulfate, were believed to contribute to the preservation and reduction of the rate of vacuolization of endothelial cells. 8 The presence of 2 mM glutamine as a supplement in the Eusol-C has been proposed to act as a compensating factor for the absence of the additives that are otherwise present in Optisol-GS. 8,9…”

“…8 The presence of 2 mM glutamine as a supplement in the Eusol-C has been proposed to act as a compensating factor for the absence of the additives that are otherwise present in Optisol-GS. 8,9…”