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白内障手术期间前房内使用标准剂量头孢呋辛后的视网膜毒性。

Retinal toxicity after intracameral use of a standard dose of cefuroxime during cataract surgery.

作者信息

Faure Céline, Perreira Daniel, Audo Isabelle

机构信息

Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France,

出版信息

Doc Ophthalmol. 2015 Feb;130(1):57-63. doi: 10.1007/s10633-014-9465-7. Epub 2014 Oct 16.

Abstract

PURPOSE

We report the clinical findings and retinal function of a patient who presented retinal toxicity signs after cefuroxime use for a phacoemulsification surgery.

METHODS

A 64-year-old man underwent a technically uneventful left eye cataract surgery. A standard intracameral dose of cefuroxime (0.1 mL of 10.0 mg/mL solution) was administered at the end of the surgery.

RESULTS

At review 2 days later, he complained about left eye visual loss. Fundus examination revealed a diffuse retinal pallor with small intraretinal cysts. Optical coherence tomography scans showed a large retinal serous detachment with a schisis-like appearance of the outer nuclear layer. A slight global retinal dysfunction was recorded on ISCEV full-field electroretinogram. Fast clinical recovery was observed. Optical coherence tomography scans were back to normal within less than a week. Two months later, full-field electroretinogram showed no longer abnormalities.

CONCLUSION

It is the first report to our knowledge of a case of retinal toxicity with a standard dose. Kinetics and studies about cefuroxime toxicity are reviewed and discussed.

摘要

目的

我们报告了一名患者在白内障超声乳化手术中使用头孢呋辛后出现视网膜毒性体征的临床发现和视网膜功能情况。

方法

一名64岁男性接受了技术上顺利的左眼白内障手术。在手术结束时给予标准前房内剂量的头孢呋辛(0.1 mL 10.0 mg/mL溶液)。

结果

术后2天复查时,他抱怨左眼视力下降。眼底检查发现视网膜弥漫性苍白并伴有小的视网膜内囊肿。光学相干断层扫描显示视网膜浆液性脱离范围较大,外核层呈劈裂样外观。国际临床视觉电生理学会(ISCEV)全视野视网膜电图记录到轻度的整体视网膜功能障碍。观察到临床快速恢复。光学相干断层扫描在不到一周内恢复正常。两个月后,全视野视网膜电图显示不再有异常。

结论

据我们所知,这是首例关于标准剂量引起视网膜毒性的报告。对头孢呋辛毒性的动力学及相关研究进行了回顾和讨论。

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