Transient macular edema after intracameral injection of a moderately elevated dose of cefuroxime during phacoemulsification surgery.

Abstract

IMPORTANCE:

Intracameral injection of cefuroxime sodium (1 mg/0.1 mL) has been reported to reduce the risk of endophthalmitis following cataract surgery. In the United States it must be compounded, which is subject to dilution error. We describe a series of 13 eyes that received intracameral injection of cefuroxime sodium, 9 mg/0.1 mL, intraoperatively.

OBSERVATIONS:

On postoperative day 1, 6 of 13 eyes (46%; 95% CI, 19%-75%) had visual acuity of 20/70 or worse and macular edema. Spectral-domain optical coherence tomography of 2 eyes revealed central subfield thicknesses of 909 and 873 µm. On postoperative day 4, the mean (SD) central subfield thickness was 309 (78) µm in the 6 eyes with diagnosed macular edema, 279 (23) µm in the fellow eyes, and 271 (38) µm in the 7 exposed eyes without macular edema. The mean (SD) time to resolution of macular edema was 5.2 (1.3) days; the final central subfield thickness ranged from 193 to 293 µm. All eyes, except 2 with preexisting ocular comorbidity, had a best-corrected final visual acuity at 1 month of 20/30 or better. Significant corneal edema was not observed.

CONCLUSIONS AND RELEVANCE:

Intracameral injection of cefuroxime sodium at a dose of 9 mg/0.1 mL was associated with transient macular edema and diminished visual acuity in 6 of 13 exposed eyes (46%), resolving largely within 1 week.

• Authors: David C Wong, Michael D Waxman, Lisa J Herrinton, Neal H Shorstein
• Journal: JAMA ophthalmology (JAMA Ophthalmol) Vol. 133 Issue 10 Pg. 1194-7 (Oct 2015) ISSN: 2168-6173 [Electronic] United States
• PMID: 26226062 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Cefuroxime

Topics

• Anterior Chamber (drug effects)
• Anti-Bacterial Agents (administration & dosage, adverse effects)
• Cefuroxime (administration & dosage, adverse effects)
• Drug Compounding (adverse effects)
• Follow-Up Studies
• Humans
• Injections, Intraocular
• Lens Implantation, Intraocular
• Macular Edema (chemically induced, diagnosis)
• Phacoemulsification
• Tomography, Optical Coherence
• Visual Acuity (drug effects)