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Svetozarskiy S.N.

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

Andreev A.N.

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

Complications of intracameral cefuroxime in cataract surgery

Authors:

Svetozarskiy S.N., Andreev A.N.

More about the authors

Journal: Russian Annals of Ophthalmology. 2018;134(5): 104‑110

DOI: 10.17116/oftalma2018134051104

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COMPLICATIONS OF INTRACAMERAL CEFUROXIME IN CATARACT SURGERY
COMPLICATIONS OF INTRACAMERAL CEFUROXIME IN CATARACT SURGERY

To cite this article:

Svetozarskiy SN, Andreev AN. Complications of intracameral cefuroxime in cataract surgery. Russian Annals of Ophthalmology. 2018;134(5):104‑110. (In Russ.)
https://doi.org/10.17116/oftalma2018134051104

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Intracameral injection of cefuroxime during phacoemulsification is considered effective in preventing endophthalmitis. Its widespread usage has led to the accumulation of data on local and systemic adverse reactions. The analysis of complications of cataract surgery with cefuroxime injections described in literature has allowed identifying a few different clusters of toxic and allergic reactions to intracameral cefuroxime for the first time. These clusters included toxic anterior segment syndrome, serous retinal detachment with macular edema, retinal hemorrhagic infarction and anaphylactic reaction. The first two types develop in the cases of both correct and incorrect dosages, and both have favorable prognosis. Retinal hemorrhagic infarction was observed in cases with more than 50 mg intracameral antibiotic injected in the anterior chamber and was accompanied by persistent irreversible visual deterioration. Anaphylactic shock in response to a standard dose of intracameral cefuroxime was described in patients allergic to penicillin. Every clinical variant has specific complication mechanisms, prevention and treatment options. Antibiotic dilution done by medical staff accounts for the risk of incorrect dosage and related complications. Clinical manifestations of the complications of antibiotic prophylaxis should be considered when specifying the causes of decreased vision in the early postoperative period.

Keywords:

toxicity
allergy
antibiotic
phacoemulsification
endophthalmitis
retinal detachment
off-label drugs use

Authors:

Svetozarskiy S.N.

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

Andreev A.N.

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

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