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 12.5 mg/0.1 ml 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 1 mg/0.1 ml 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.
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