Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey.
Graefes Arch Clin Exp Ophthalmol. 2010 Mar;248(3):415-20. doi: 10.1007/s00417-009-1267-3.
To investigate the biochemical changes of the oxidant/antioxidant balance in corneal tissue, and determine the relative corneal endothelial toxicities of the following intracameral antibiotic agents: cefuroxime and vancomycin.
The experiment was conducted using New Zealand rabbits. The rabbits were randomly divided into three experimental groups as follows: cefuroxime group (n=10), vancomycin group (n=10), and control group (n=10). Only the right eyes of the rabbits were used in this study. Twenty eyes received injections of 0.1 ml of one of the two antibiotic preparations, and ten control eyes received injections of 0.1 ml of balanced salt solution. Corneal thickness and clarity were measured before, and 3 and 6 h after surgery. The corneal tissues of the rabbits were extracted and homogenized in 2 ml of physiological saline, and kept at -80 degrees C. In the corneal tissue, malondialdehyde (MDA) and total thiol (SH) levels were measured with spectrophotometric methods. Friedman and Kruskal-Wallis tests were used for statistical analysis.
Neither cefuroxime nor vancomycin caused corneal thickening and edema at 3 and 6 h after injection, and no anterior chamber reaction was observed in both groups at both measurement times. The level of SH significantly decreased, while the level of MDA significantly increased in the corneal tissue in the cefuroxime group (p=0.001 and p<0.001 respectively). In contrast, no statistically significant change in oxidative-stress parameters was observed in the vancomycin group (p=0.165 and p=0.876 respectively).
Corneal endothelial cells are very sensitive to any form of toxic exposure. Using intracameral cefuroxime during the anterior segment surgery may be more toxic on the endothelial tissue in patients with vulnerable corneal endothelium. Because of the definite risk of dosage errors, these agents should be prepared in the hospital pharmacy and not in the operating theatre.
研究氧化剂/抗氧化剂平衡的生化变化，并确定以下眼内抗生素制剂对角膜内皮的相对毒性：头孢呋辛和万古霉素。
本实验采用新西兰兔。将兔子随机分为三组：头孢呋辛组（n=10）、万古霉素组（n=10）和对照组（n=10）。本研究仅使用兔子的右眼。20 只眼分别注射 0.1ml 两种抗生素制剂之一，10 只对照眼注射 0.1ml 平衡盐溶液。手术前、后 3 小时和 6 小时测量角膜厚度和清晰度。将兔子的角膜组织提取并在 2ml 生理盐水中匀浆，保存在-80°C。在角膜组织中，用分光光度法测量丙二醛（MDA）和总巯基（SH）水平。采用 Friedman 和 Kruskal-Wallis 检验进行统计分析。
头孢呋辛和万古霉素在注射后 3 小时和 6 小时均未引起角膜增厚和水肿，两组在两个测量时间均未观察到前房反应。头孢呋辛组角膜组织中 SH 水平显著降低，MDA 水平显著升高（p=0.001 和 p<0.001）。相比之下，万古霉素组氧化应激参数无统计学显著变化（p=0.165 和 p=0.876）。
角膜内皮细胞对外界任何形式的毒性暴露都非常敏感。在前节手术中使用眼内头孢呋辛可能对脆弱角膜内皮的患者内皮组织更具毒性。由于剂量错误的风险明确，这些药物应在医院药房而不是手术室配制。
