Xiao Hui, Liu Xing, Guo Xinxing
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sun University, Xianlie South Road No 54, Guangzhou, 510060, China.
BMC Res Notes. 2015 Nov 4;8:647. doi: 10.1186/s13104-015-1639-1.
Macular edema and detachment at the first day after an uneventful cataract surgery is very rare, and has been reported previously with the use of high concentrations of intra-cameral cefuroxime. However, we hereby reported two cases of macular edema with extensive serous retinal detachment the first day after an uneventful phacoemulsification with intra-cameral injection of a standard dose of cefuroxime during the procedure.
A 68-year-old female and a 63-year-old male without any special history both underwent an uneventful phacoemulsification surgery and 1 mg/0.1 ml of cefuroxime solution was injected into the anterior chamber at the end of the procedure. Macular edema with extensive serous retinal detachment around macula and optic disc area were observed the first day after surgery. Without surgical intervention, a quick recovery of the macular edema and retinal detachment was observed by spectral domain optical coherence tomography 1 week later in both cases.
We presume that the retina injury in the two cases may be attributed to cefuroxime toxicity even under a use of a standard dose. But the retinal damages are restorable and routine anti-inflammatory treatment is enough.
在白内障手术顺利完成后的第一天出现黄斑水肿和脱离的情况非常罕见，此前曾有报道与使用高浓度前房内注射头孢呋辛有关。然而，我们在此报告两例在超声乳化白内障吸除术过程中前房内注射标准剂量头孢呋辛后第一天出现黄斑水肿并伴有广泛浆液性视网膜脱离的病例。
一名68岁女性和一名63岁男性，均无特殊病史，均接受了顺利的超声乳化白内障吸除术，手术结束时在前房内注射了1mg/0.1ml的头孢呋辛溶液。术后第一天观察到黄斑水肿，并伴有黄斑及视盘区域周围广泛的浆液性视网膜脱离。在未进行手术干预的情况下，1周后通过频域光学相干断层扫描观察到两例患者的黄斑水肿和视网膜脱离均迅速恢复。
我们推测这两例患者的视网膜损伤可能归因于即使使用标准剂量的头孢呋辛也存在的毒性作用。但视网膜损伤是可恢复的，常规抗炎治疗就足够了。
