Abstract：
OBJECTIVE: To describe intracameral toxic effects of cefuroxime at a higher dose than recommended in cataract surgery.
METHODS: Retrospective study of 8 eyes of 8 patients who inadvertently received 12.5mg/0.1ml of intracameral cefuroxime due to a dilution error, at the end of the cataract surgery. All patients underwent a strict ophthalmology follow-up for 6 months.
RESULTS: All patients presented with a marked anterior segment inflammation with corneal oedema that resolved completely in all cases (between 5 days and 3 months). At 6 months of follow-up a statistically significant difference was found in the corneal endothelial cell density when compared with the fellow eye (P=.038), being<1000 cells/mm2 in 3 cases. Three patients (37.5%) showed early macular oedema, with subfoveal ellipsoid layer disruption in one case as a permanent sequel. One patient developed an optic neuropathy with associated afferent pupillary defect.
CONCLUSIONS: Although 1mg/0.1ml of intracameral cefuroxime has been shown to reduce the incidence of endophthalmitis, its overdose can have potentially toxic eye effects in both anterior and posterior segments.
METHODS: Retrospective study of 8 eyes of 8 patients who inadvertently received 12.5mg/0.1ml of intracameral cefuroxime due to a dilution error, at the end of the cataract surgery. All patients underwent a strict ophthalmology follow-up for 6 months.
RESULTS: All patients presented with a marked anterior segment inflammation with corneal oedema that resolved completely in all cases (between 5 days and 3 months). At 6 months of follow-up a statistically significant difference was found in the corneal endothelial cell density when compared with the fellow eye (P=.038), being<1000 cells/mm2 in 3 cases. Three patients (37.5%) showed early macular oedema, with subfoveal ellipsoid layer disruption in one case as a permanent sequel. One patient developed an optic neuropathy with associated afferent pupillary defect.
CONCLUSIONS: Although 1mg/0.1ml of intracameral cefuroxime has been shown to reduce the incidence of endophthalmitis, its overdose can have potentially toxic eye effects in both anterior and posterior segments.
摘要：
目的：描述头孢呋辛在白内障手术中的剂量高于推荐剂量的前房内毒性作用。
方法：对8例患者的8只眼进行回顾性研究，这些患者由于稀释误差而无意中接受了12.5mg/0.1ml头孢呋辛，在白内障手术结束时。所有患者均接受了为期6个月的严格眼科随访。
结果：所有患者均出现明显的眼前节炎症伴角膜水肿，在所有情况下（5天至3个月之间）完全消退。在随访6个月时，与同眼相比，发现角膜内皮细胞密度有统计学意义的差异（P=0.038），在3种情况下<1000个细胞/mm2。3例患者（37.5%）出现早期黄斑水肿，在一种情况下，中央凹下的椭圆体层破裂是永久的续集。一名患者出现视神经病变并伴有传入瞳孔缺损。
结论：虽然前房内注射1mg/0.1ml头孢呋辛可降低眼内炎的发生率，它的过量可能对前段和后段都有潜在的毒性作用。
方法：对8例患者的8只眼进行回顾性研究，这些患者由于稀释误差而无意中接受了12.5mg/0.1ml头孢呋辛，在白内障手术结束时。所有患者均接受了为期6个月的严格眼科随访。
结果：所有患者均出现明显的眼前节炎症伴角膜水肿，在所有情况下（5天至3个月之间）完全消退。在随访6个月时，与同眼相比，发现角膜内皮细胞密度有统计学意义的差异（P=0.038），在3种情况下<1000个细胞/mm2。3例患者（37.5%）出现早期黄斑水肿，在一种情况下，中央凹下的椭圆体层破裂是永久的续集。一名患者出现视神经病变并伴有传入瞳孔缺损。
结论：虽然前房内注射1mg/0.1ml头孢呋辛可降低眼内炎的发生率，它的过量可能对前段和后段都有潜在的毒性作用。
