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

JAMA Ophthalmol. 2015 Oct;133(10):1194-7. doi: 10.1001/jamaophthalmol.2015.2421.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

  • Anti-Bacterial Agents
  • Cefuroxime