Ocular toxicity after inadvertent overdose of intracameral cefuroxime during cataract surgery.

Purpose: 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/mm 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.