Intracameral cefuroxime in combined pars plana vitrectomy and phacoemulsification: a study of safety

Abstract

Gianluca Besozzi,1 Attilio Di Salvatore,2 Daniele Cardillo,2 Alessandro Finzi,2 Joseph Sajish Pinackatt,2 Andrea Baldi,2 Alessandro Monfardini,2 Valeria Forioli,2 Rino Frisina,3 Barbara Parolini2 1Department of Ophthalmology, Vito Fazzi Hospital, Lecce, Italy; 2Department of Ophthalmology, Sant’Anna Clinical Institute, Brescia, Italy; 3Department of Ophthalmology, Padova University Hospital, Padova, Italy Background: Postoperative endophthalmitis is a severe complication after intraocular surgery. The aim of this pilot study was to investigate the safety of intracameral cefuroxime in combined vitrectomy and phacoemulsification for cataract and various vitreoretinal disease.Methods: The charts of 152 patients who underwent combined phacoemulsification, intraocular lens implant and pars plana vitrectomy were reviewed. The final tamponade was chosen among fluid, air, gas or silicone oil, based on the requirement of each single case. Patients were operated on by four different surgeons. At the end of surgery, 1 mg/0.1 mL of intracameral cefuroxime (Aprokam) was administered.Results: The mean follow-up was 6.26±7.78 months (range 1–12). No retinal complication, such as retinal infarction or hemorrhages were observed. No acute macular serous detachment and no new intraretinal cysts were noted, in those patients who received optical coherence tomography within the fifth day after surgery. No endophthalmitis was recorded.Conclusion: Intracameral cefuroxime, at the end of combined phacoemulsification and pars plana vitrectomy, is safe as it has no toxicity on the retina and maybe could be considered effective in endophthalmitis prevention. Due to the relatively small number of patients, further studies are advisable.Summary statement: The standard dose of intracameral cefuroxime at the end of combined phacoemulsification and pars plana vitrectomy has no toxic effects on the retina. This paper/The abstract of this paper was presented at the European Vitreo Retinal Society Conference 2017 as a conference talk with interim findings. The poster’s abstract was not published. Keywords: antibiotics retinal toxicity, cefuroxime, combined surgery, endophthalmitis prevention, intracameral cefuroxime, pars plana vitrectomy, phacoemulsification

Keywords

• Antibiotics retinal toxicity Cefuroxime Combined surgery Endophthalmitis prevention Intracameral cefuroxime Pars plana vitrectomy Phacoemulsification