Macular Toxicity of Low-Concentration Cefuroxime during Cataract Surgery in Vitrectomized Eyes

Abstract

Objective: The objective of this study was to determine the toxic effect and clinical characteristics of 1 mg/ml cefuroxime sodium on retinas after phacoemulsification in vitrectomized eyes. Methods: Cataract patients with vitrectomized eyes were studied retrospectively. Phacoemulsification combined with intraocular lens implantation was performed uneventfully. Best Corrected Visual Acuity（BCVA）, intraocular pressure（IOP）, fundus photography, macular central thickness, and angiography were collected and analyzed. They were studied in patients with macular edema to evaluate macular toxicity. Results: 92 cases (92 eyes) were enrolled, including 44 eyes of males and 48 eyes of females with an average age of 55.35 ± 12.32 years. Univariate analysis showed that the intraoperative use of balanced salt solution (BSS) containing 1 mg/ml cefuroxime sodium compound electrolyte and macular involvement in primary vitrectomy were important risk factors for macular edema on the first day after cataract surgery (P < 0.05). In addition, the characteristics of this kind of macular edema were studied; the thickness of macular fovea was significantly high at 1-day follow-up (P < 0.05), but there was no difference between pre-operation and 1-week post-operation (P > 0.05). Conclusion: Low-concentration cefuroxime sodium can cause acute macular edema in vitrectomized eyes, which can heal within one week after surgery.

Toxicity to the macula after using small doses cefuroxime for phacoemulsification and vitrectomy combined surgery

“…Intracameral cefuroxime injection (1 mg/0.1 mL) during cataract surgery was found to be beneficial in reducing the risk of postoperative endophthalmitis [1][2][3] . At the recommended dose of 1.0 mg in 0.1 mL, cefuroxime presents no ocular toxicity and is well tolerated [4][5][6] . Acute macular edema with retinal detachment after cataract surgery is very rare [7] .…”