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.
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。