Cefuroxime Dilution Error

Abstract

Inadvertent intracameral (3 mg in 0.1 mL) cefuroxime injection did not cause any detectable adverse effect on ocular tissues.

Intracameral cefuroxime injection at the end of cataract surgery to reduce the incidence of endophthalmitis: French study

“…Moreover, the study found that immunoglobulin E-mediated allergy was rare, with 39 reported that the clinically used concentration of cefuroxime seems to be safe to the endothelium. In addition, studies of dosing errors [39][40][41] found that even after a high-dose injection of cefuroxime, the endothelial cell count and retinal function completely recovered after 6 weeks. Delyfer et al 40 found that intracameral injection of very high doses of cefuroxime induced anterior and posterior inflammation (extensive macular edema associated with a large serous retinal detachment and fluorescein angiograms showing diffuse leakage without abnormal retinal perfusion); however, in all cases, the final visual outcome was satisfactory without surgical intervention.…”

“…The macular thickness (mean 288.4 mm G 22.6 [SD]) and profile returned to normal in all patients, although electroretinogaphy recordings showed reduced rod photoreceptor cell function (P!.05). 40 In a study by Sakarya and Sakarya,41 inadvertent intracameral cefuroxime injection (3.0 mg in 0.1 mL) in 6 eyes did not cause a detectable adverse effect on ocular tissues. In our study, 15 of 2289 patients were allergic to beta-lactams.…”

Macular infarction after inadvertent intracameral cefuroxime

“…Numerous studies of the safety of intracameral cefuroxime have been published. [2][3][4] Our patient received an effective dose of approximately 62.5 mg, which after washout should have been reduced. Intracameral cefuroxime concentration has been shown to decrease to approximately 35% of the initial concentration after 60 minutes.…”

Ocular toxicity after intracameral injection of very high doses of cefuroxime during cataract surgery

“…Minor dilution errors have occurred in the past without incidence. 17 Here, however, we report 6 cases of intraocular inflammation after intracameral injection of a very high dose of cefuroxime secondary to misunderstanding of the dilution protocol at the end of uneventful cataract surgery.…”