Randomized controlled trial on the safety of intracameral cephalosporins in cataract surgery

Abstract

Objective:To compare the safety profiles of intracameral cephalosporins in cataract surgery.Patients and methods:In this controlled trial, 129 patients were randomized to one of four groups to receive 1 mg of one of three cephalosporins – cefazolin, cefuroxime, or ceftazidime, or normal saline – given intracamerally during cataract surgery. Central endothelial cell density (ECD) and retinal center point thickness (CPT) were determined by specular microscopy and ocular coherence tomography, respectively, before and at 3 months after surgery.Results:There were no statistical significant differences in the changes of ECD and CPT between eyes receiving intracameral cephalosporin and control.Conclusion:The use of intracameral cefazolin, cefuroxime, or ceftazidime (1 mg in 0.1-mL solution) at the time of cataract surgery had no significant effect on ECD and CPT postoperatively.

Macular edema with serous retinal detachment post-phacoemulsification followed by spectral domain optical coherence tomography: a report of two cases

“…Acute macular edema with retinal detachment after cataract surgery is very rare, and has been reported previously with the use of high concentrations of intra-cameral cefuroxime [ 3 , 4 ]. Cefuroxime is commonly used during phacoemulsification procedure [ 5 ] and has been proved to be safe with a standard dose previously [ 6 – 8 ]. However, we hereby report two cases of macular edema with extensive serous retinal detachment that was immediately detected by spectral domain optical coherence tomography (SD-OCT) the first day after an uneventful phacoemulsification with intra-cameral injection of standard doses of cefuroxime during the procedure.…”

Complications of intracameral cefuroxime in cataract surgery

“…Частично обратимое снижение амплитуды пиков электроретинограммы и нарушение гистологической структуры сетчатки было установлено при интравитреальном введении 10 мг цефуроксима [16]. Введение последнего в переднюю камеру в дозе 1 мг в 0,1 мл клинически безопасно, не вызывает развития макулярного отека и не увеличивает потери эндотелиальных клеток роговицы после факоэмульсификации катаракты [17][18][19][20].…”

Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime

“…These radicals may cause endothelial damage and anterior segment reaction. On the other hand, Lam et al 17 reported no significant differences in the changes of endothelial cell density and central macular thickness between eyes receiving intracameral cephalosporin including cefuroxime and the control group. Montan et al 18 also reported no corneal damage and irreversible effect of intracameral use of cefuroxime.…”