Serous retinal detachment after phacoemulsification with intracameral cefuroxime (a case-control report)

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Serous retinal detachment is a rare postoperative complication of phacoemulsification with intracameral antibiotics. Diagnostic and therapeutic strategy in such cases is not well known. Purpose: to present a case of serous retinal detachment after phacoemulsification with intracameral cefuroxime. Material and methods. A retrospective analysis of the medical record of one patient who had underwent cataract phacoemulsification on both eyes; the follow-up period was 5 months. Results. Phacoemulsification of noncomplicated cataract with implantation of intraocular lens in the right eye was completed uneventfully; 1 mg of cefuroxime was administered into the anterior chamber at the end of the surgery. In the first day after the surgery visual acuity decreased to 0.2. Serous detachment of retinal pigment and sensory epithelia in the macula area was revealed by optical coherence tomography (OCT). Fluorescein angiography showed no pathological vascular activity. The patient received standard post-surgery therapy supplemented with subtenon triamcinolone, intravenous dexamethasone injections and systemic acetazolamide ingestion. The retinal detachment status was monitored daily by OCT. By day 6 of the follow-up visual acuity recovered to 1.0. After 5 months, inner retinal profile deformation was revealed. The patient’s left eye was considered the «control» eye; phacoemulsification without cefuroxime was performed on it 5 months after the initial surgery, and no complication occurred during the follow-up. Conclusion. Serous detachment of retinal pigment and sensory epithelia during the early postoperative period after cataract surgery may be caused by a toxic reaction to intracameral cefuroxime even when it's administered in standard dosage. This complication has a favorable prognosis, but requires long term monitoring.

Keywords:

toxicity

allergy

antibiotic

cataract

endophthalmitis

neuroepithelium detachment

optical coherence tomography

Authors:

Andreev A.N.

Volga District Medical Centre, Federal Medical and Biological Agency, 2 Nizhnevolgskaya Naberegnaya, Nizhny Novgorod, Russian Federation, 603001

Svetozarskiy S.N.

Nizhny Novgorod State Medical Academy, Ministry of Health of the Russian Federation, 10/1 Minina Sq., Nizhny Novgorod, Russian Federation, 603005

List of references:

Malyugin BE. State-of-the-art cataract surgery and intraocular optical correction. Vestnik oftal’mologii. 2014;130(6):80-88. (In Russ.)
Linertova R, Garcia-Perez L, Alonso-Plasencia M et al. Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness. OPTH. 2014;1515. https://doi.org/10.2147/opth.s59776
Katz G, Blum S, Leeva O et al. Intracameral cefuroxime and the incidence of post-cataract endophthalmitis: an Israeli experience. Graefes Arch Clin Exp Ophthalmol. 2015;253(10):1729-1733. https://doi.org/10.1007/s00417-015-3009-z
Barry P, Seal D, Gettinby G, Lees F, Peterson M, Revie C. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery. Journal of Cataract & Refractive Surgery. 2006;32(3):407-410. https://doi.org/10.1016/j.jcrs.2006.02.021
Kessel L, Flesner P, Andresen J, Erngaard D, Tendal B, Hjortdal J. Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta-analysis. Acta Ophthalmologica. 2015;93(4):303-317. https://doi.org/10.1111/aos.12684
Daien V, Papinaud L, Gillies M et al. Effectiveness and Safety of an Intracameral Injection of Cefuroxime for the Prevention of Endophthalmitis After Cataract Surgery With or Without Perioperative Capsular Rupture. JAMA Ophthalmol. 2016;134(7):810. https://doi.org/10.1001/jamaophthalmol.2016.1351
Gupta M, McKee H, Saldaña M, Stewart O. Macular thickness after cataract surgery with intracameral cefuroxime. Journal of Cataract & Refractive Surgery. 2005;31(6):1163-1166. https://doi.org/10.1016/j.jcrs.2004.10.074
Montan P, Wejde G, Setterquist H, Rylander M, Zetterström C. Prophylactic intracameral cefuroxime. Journal of Cataract & Refractive Surgery. 2002;28(6):982-987. https://doi.org/10.1016/s0886-33
Buyukyildiz H, Gulkilik G, Kumcuoglu Y. Early serous macular detachment after phacoemulsification surgery. Journal of Cataract & Refractive Surgery. 2010;36(11):1999-2002. https://doi.org/10.1016/j.jcrs.2010.07.007
Delyfer M, Rougier M, Leoni S et al. Ocular toxicity after intracameral injection of very high doses of cefuroxime during cataract surgery. Journal of Cataract & Refractive Surgery. 2011;37(2):271-278. https://doi.org/10.1016/j.jcrs.2010.08.047
Zakir S, Shukla M, Simi Z, Ahmad J, Sajid M. Serum cortisol and testosterone levels in idiopathic central serous chorioretinopathy. Indian J Ophthalmol. 2009;57(6):419. https://doi.org/10.4103/0301-4738.57143.50(01)01270-6
Lockington D, Flowers H, Young D, Yorston D. Assessing the accuracy of intracameral antibiotic preparation for use in cataract surgery. Journal of Cataract & Refractive Surgery. 2010;36(2):286-289. https://doi.org/10.1016/j.jcrs.2009.08.034
Le Dû B, Pierre-Kahn V. Early macular edema after phacoemulsification and suspected overdose of cefuroxime: report of six cases. J Fr Ophtalmol. 2014;37(3):202-210. https://doi.org/10.1016/j.jfo.2013.06.007
Xiao H, Liu X, Guo X. Macular edema with serous retinal detachment post-phacoemulsification followed by spectral domain optical coherence tomography: a report of two cases. BMC Research Notes. 2015;8(1). https://doi.org/10.1186/s13104-015-1639-1
Faure C, Perreira D, Audo I. Retinal toxicity after intracameral use of a standard dose of cefuroxime during cataract surgery. Documenta Ophthalmologica. 2014;130(1):57-63. https://doi.org/10.1007/s10633-014-9465-7
Purslow C, Davey K, Johnson M, Pietri G, Suri G. Budget impact assessment of Aprokam compared with unlicensed cefuroxime for prophylaxis of post-cataract surgery endophthalmitis. BMC Ophthalmology. 2015;15(1). https://doi.org/10.1186/s12886-015-0056-5
Keating G. Intracameral Cefuroxime. Drugs. 2013;73(2):179-186. https://doi.org/10.1007/s40265-013-0011-9
Wong D, Waxman M, Herrinton L, Shorstein N. Transient Macular Edema After Intracameral Injection of a Moderately Elevated Dose of Cefuroxime During Phacoemulsification Surgery. JAMA Ophthalmol. 2015;133(10):1194. https://doi.org/10.1001/jamaophthalmol.2015.2421
Çiftçi S, Çiftçi L, Dağ U. Hemorrhagic Retinal Infarction Due to Inadvertent Overdose of Cefuroxime in Cases of Complicated Cataract Surgery: Retrospective Case Series. American Journal of Ophthalmology. 2014;157(2):421-425.e2. https://doi.org/10.1016/j.ajo.2013.10.018
Qureshi F, Clark D. Macular infarction after inadvertent intracameral cefuroxime. Journal of Cataract & Refractive Surgery. 2011;37(6):1168-1169. https://doi.org/10.1016/j.jcrs.2011.03.032

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