Risk of Macular Toxicity After Intra-Cameral 1mg/0.1 ml Cefuroxime for Endophthalmitis Prophylaxis in Phacoemulsification Cataract Surgery

Abstract

The world's leading culprit of preventable blindness is cataracts. For numerous decades, postoperative endophthalmitis has instilled terror as a potential complication of cataract surgery. Objective: To determine the frequency of retinal toxicity in terms of transient macular edema following using per-operative intracameral cefuroxime 1mg/0.1ml for endophthalmitis prophylaxis. Methods: A Descriptive case series was done at LRBT Eye Hospital, Lahore, from 15th Dec 2020 to 14th Jun 2021. A total number of 118 senile cataract patients were included. After cataract surgery, an intracameral 1 mg injection of cefuroxime was given to each patient. The optimally corrected visual acuity and macular thickness at the center of the retina on OCT were assessed postoperatively at week 1. If they were found to be elevated, it was labeled as retinal toxicity. Data were collected on data collection proforma. Results: The average age of the participants was 59.68 ± 5.28 years. Mean visual acuity before and after surgery was 2.01 ± 0.74 and 1.92 ± 0.94, respectively. Mean central macular thickness before and after surgery was 241.08 ± 4.73 and 248.74 ± 5.86 µm, respectively. There were 71 (60.17%) male and 47 (39.83%) female patients. There were 42 (35.59%) farmers, 40 (33.90%) job holders, 05 (4.24%) business people, and 31 (26.27%) non-working patients. Retinal toxicity was found in 54 (45.76%) patients. Conclusions: Intracameral injection of cefuroxime sodium can result in transient macular edema and retinal toxicity. In this study, retinal toxicity occurred in 45.8% of patients undergoing phacoemulsification.