Cost–Benefit and Cost–Utility Analysis of Amphotericin B Supplementation of Corneal Storage Media With Endothelial Keratoplasty-Prepared Tissue

Chiang, Trent Tsun-Kang; Shtein, Roni M.; McCoy, Kristen; Hurlbert, Susan; Grossman, Gregory H.

doi:10.1097/ico.0000000000002242

Cited by 8 publications

(12 citation statements)

References 38 publications

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“…It was concluded that amphotericin B supplementation is cost-effective and can prevent more than 69.62% of the post-EK fungal infections. [ 29 ] Based on this current experiment, the lowest concentration with a higher efficacy was observed with amphotericin B (0.5 μg/mL). Future research on endothelial toxicity (currently experiments are under process) with the above concentrations can guide us about the correct dosage and choice of the drug.…”

Section: Discussionmentioning

confidence: 76%

Efficacy of voriconazole and amphotericin B in corneal preservative media

Das¹,

Mitra

Garg

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To evaluate the efficacy of voriconazole and amphotericin B in McCarey–Kaufman (MK) media. Methods: MK media vials were supplemented with either voriconazole at 1, 2, 20, 50, 100 μg/mL or amphotericin B at 0.5, 1, 2, 10, 20 μg/mL. The standard inoculum of the American Type Culture Collection (ATCC) strain of Candida albicans , Aspergillus flavus , and Fusarium keratinoplasticum was added to the set of vials. The efficacy outcomes were calculated as ‘viable fungal colony counts’ determined from the samples taken on Days 0 and 4. MK media containing fungal inoculum but without antifungal supplements were used as control. Results: In the voriconazole arm, on Day 4, a reduction in the colony count was observed for Candida albicans (1 μg/mL, 36%; 100 μg/mL, 100%), Aspergillus flavus (1 μg/mL, 53.8%; 100 μg/mL, 80.4%), and Fusarium keratinoplasticum (1 μg/mL, 39.0%; 100 μg/mL, 72.2%). Similarly, in the amphotericin B arm, on Day 4, a reduction in the colony count was observed for Candida albicans (0.5 μg/mL; 99.9%; 20 μg/mL, 100%), Aspergillus flavus (0.5 μg/mL, 65.2%; 20 μg/mL, 84.8%), and Fusarium keratinoplasticum (0.5 μg/mL, 90.1%; 20 μg/mL, 100%). Conclusion: Compared to voriconazole, the addition of amphotericin B significantly reduces fungal contamination in MK media.

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Section: Discussionmentioning

confidence: 76%

Efficacy of voriconazole and amphotericin B in corneal preservative media

Das¹,

Mitra

Garg

et al. 2021

Indian Journal of Ophthalmology

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“…Therefore, a review of post-EK keratitis/endophthalmitis found supplementation of amphotericin B to be effective in the corneal storage solution at a $100,000 qualityadjusted life-year level and if the intervention can prevent 70% of post-EK fungal infections. 68 Two commentaries were recently published advocating the pros 69 and cons 70 of supplementing corneal storage solutions with antifungals. After an increase in popularity of EK, fungal endophthalmitis post-EK 35 2000…”

Section: Antifungal Coverage and Cost-effectiveness In Hypothermic Co...mentioning

confidence: 99%

Overview of Short-Term and Intermediate-Term Corneal Storage Solution: Comparison of Clinical Outcomes and Need For Future Research

Roy

Jeng

Chaurasia

et al. 2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Corneal donor tissue preservation techniques have incrementally improved since the introduction of McCarey-Kaufman storage solution from short-term storage to intermediate duration of storage with the advent of organ culture and Optisol GS storage solutions. Improved understanding of the corneal endothelial cell physiology has helped in designing newer storage solutions, such as the Life 4C and Cornea Cold. The incorporation of antibiotics, ATP precursors, minerals, and vitamins has improved the viability of tissues. In addition, these modifications to the newer storage solutions have increased the endothelial longevity and metabolic activity. Despite these advances, the duration of tissue storage has largely been restricted to 2 weeks in Optisol GS and 4 weeks in organ culture. The role and cost-effectiveness of antifungal supplementation and the need for improved epithelial preservation are additional areas that need to be explored. This review intends to summarize the efficacy and viability of donor corneas in different tissue storage solution and compare clinical outcomes while providing an insight into the challenges in developing newer methods of corneal preservation.

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“…[38][39][40][41] Gibbons et al and Chiang et al evaluated the cost-effectiveness of antifungal supplementation and found that amphotericin B supplementation could be cost-effective in reducing the risk of fungal infections with endothelial grafts. 42,43 However, the hypothermic conditions may affect the pharmacokinetics of amphotericin. 16 A recent publication evaluated the effects of adding 0.255 ug/ml amphotericin to Optisol solution (Bausch & Lomb Inc, Bridgewater, NJ).…”

Section: Preventionmentioning

confidence: 99%

Posterior Segment Complications of Endothelial Keratoplasty

Gibbons¹,

Chang²,

Yannuzzi³

2020

International Ophthalmology Clinics

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Endothelial keratoplasty is the most commonly performed type of corneal transplant in the United States, currently accounting for 60% of total grafts. The anterior segment complications are well documented; however, the posterior segment complications may not be as familiar to the anterior segment surgeon. These include endophthalmitis, cystoid macular edema (CME), choroidal detachment, graft dislocation to the posterior segment, and retinal detachment. CME is the most common postoperative retinal complication with a reported incidence of up to 12.5%, which usually responds well to topical therapy. This article will review the incidence, prevention and management of posterior segment complications after endothelial keratoplasty.

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Cost–Benefit and Cost–Utility Analysis of Amphotericin B Supplementation of Corneal Storage Media With Endothelial Keratoplasty-Prepared Tissue

Cited by 8 publications

References 38 publications

Efficacy of voriconazole and amphotericin B in corneal preservative media

Efficacy of voriconazole and amphotericin B in corneal preservative media

Overview of Short-Term and Intermediate-Term Corneal Storage Solution: Comparison of Clinical Outcomes and Need For Future Research

Posterior Segment Complications of Endothelial Keratoplasty

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