May 21, 2013
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Intracameral cefuroxime non-toxic for the macula with proper dosing following cataract surgery

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PARIS — Prophylactic use of intracameral cefuroxime during cataract surgery was not associated with increased macular thickening in the postoperative period, according to a study.

Intracameral cefuroxime was shown in a large series to be highly effective in lowering the incidence of endophthalmitis following cataract surgery and was recommended as a routine prophylaxis by the French Agency for the Safety of Health Products, Geoffrey Dethorey, MD, said at the meeting of the French Society of Ophthalmology.

Geoffrey Dethorey, MD

Geoffrey Dethorey

"However, concerns about macular toxicity were raised following a few reported cases of macular thickening and discouraged several surgeons from using this method," he said.

In a prospective study, 37 patients were randomized to receive intracameral cefuroxime or balanced salt solution only. Best corrected visual acuity, foveal thickness and macular volume were measured before surgery and at 1 week and 1 month postoperatively by spectral-domain optical coherence tomography.

"No significant difference was found at the preoperative and postoperative visits in the cefuroxime group, nor between groups," Dethorey said.

Dethorey said macular toxicity may be a potential problem in cases of incorrect dilution and subsequent too-high concentration of the cefuroxime agent, or in cases of contamination.

Disclosure: Dethorey has no relevant financial disclosures.

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