Ocular toxicity after inadvertent overdose of intracameral cefuroxime during cataract surgery

Díez-Álvarez, L.; Salvá-Palomeque, Teresa; Jaumandreu, Laia; Gómez-Mariscal, M; Muñoz-Negrete, F.J.; Rebolleda, Gema

doi:10.1016/j.oftale.2020.12.011

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…Conflicting results regarding resolution of corneal and macular adverse events were presented with 10-fold overdosing, but after injection of 50 mg of cefuroxime, 7 of 16 patients suffered from varying degrees of vision loss. [25][26][27] As for the cefuroximeampicillin treatment, the same safety data as cited above should be valid for the cefuroxime component. However, no formal in vivo tolerance investigation on the added ampicillin dose or let alone the combination has been conducted.…”

Section: Discussionmentioning

confidence: 99%

Endophthalmitis following cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011 – 2017. A national registry study

Friling,

Bro,

Lundström

et al. 2024

J Cataract Refract Surg

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Purpose: To study the incidence, predictive factors, aetiology and visual consequences of postoperative endophthalmitis (PE) in relation to three intracameral antibiotic regimes. Setting: Swedish National Cataract Register (NCR) entries from 2011 through 2017. Design: Observational retrospective study. Methods: PE incidence, influencing factors, bacteriology and visual outcome were analyzed with regard to the three major prophylactic IC protocols. Results: The overall incidence of PE was 0.023% or 177 cases in 764 513 cataract procedures. Analyzed per intracameral regime, the rates of PE were 0.024% (126 cases in 514 916 surgeries) for cefuroxime, 0.020% (25 cases in 122 340 surgeries) for moxifloxacin and 0.017% (20 cases in 121 045 surgeries) for combined cefuroxime-ampicillin. Incidences were not statistically significantly different from one another. Gram-positive bacteria caused 89.0% of culture positive cases. Enterococci as pathogens were significantly more frequent with intracameral cefuroxime than with moxifloxacin, p = 0.006 or cefuroxime-ampicillin, p < 0.001, while streptococci other than enterococci were more common with moxifloxacin than with cefuroxime, p < 0.001. Bacterial susceptibility to the given antibiotics was demonstrated in 21.3% of PE cases treated with cefuroxime, which was statistically significantly lower than proportions found with cefuroxime-ampicillin, 60.0%, p = 0.015, or with moxifloxacin, 88.2%, p < 0.001. Visual outcome worse than 20/200 were similar in the groups ranging from 42.0% to 53.7%. Conclusion: No statistically significant differences in PE incidence or visual outcome results between treatment groups were demonstrated. However, differences in aetiology and bacterial sensitivity were found between the prophylactic intracameral treatments.

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Section: Discussionmentioning

confidence: 99%

Endophthalmitis following cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011 – 2017. A national registry study

Friling,

Bro,

Lundström

et al. 2024

J Cataract Refract Surg

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“…It achieves its bactericidal effect through the inhibition of bacterial cell wall synthesis. Ocular adverse effects of cefuroxime include intraocular inflammation [ 14 ], macular infarction with cystoid macular edema [ 15 ], and cornea edema [ 16 ]. On optical coherence tomography (OCT), serous macular detachment and disruption of the ellipsoid zone have been reported in a few cases [ 13 ].…”

Section: Cefuroximementioning

confidence: 99%

Use of Visual Electrophysiology to Monitor Retinal and Optic Nerve Toxicity

et al. 2022

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It is important for clinicians to consider exposure to toxic substances and nutritional deficiencies when diagnosing and managing cases of vision loss. In these cases, physiologic damage can alter the function of key components of the visual pathway before morphologic changes can be detected by traditional imaging methods. Electrophysiologic tests can aid in the early detection of such functional changes to visual pathway components, including the retina or optic nerve. This review provides an overview of various electrophysiologic techniques, including multifocal electroretinogram (mfERG), full-field ERG (ffERG), electrooculogram (EOG), pattern electroretinogram (PERG), and visual evoked potential (VEP) in monitoring the retinal and optic nerve toxicities of alcohol, amiodarone, cefuroxime, cisplatin, deferoxamine, digoxin, ethambutol, hydroxychloroquine, isotretinoin, ocular siderosis, pentosane, PDE5 inhibitors, phenothiazines (chlorpromazine and thioridazine), quinine, tamoxifen, topiramate, vigabatrin, and vitamin A deficiency.

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Ocular toxicity after inadvertent overdose of intracameral cefuroxime during cataract surgery

Cited by 3 publications

References 16 publications

Endophthalmitis following cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011 – 2017. A national registry study

Endophthalmitis following cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011 – 2017. A national registry study

Use of Visual Electrophysiology to Monitor Retinal and Optic Nerve Toxicity

High dose cefuroxime causing retinal toxicity in a patient undergoing trabeculectomy

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