Kamal-Salah Radua, Osoba Olayinka, Doyle Edward
Torbay Hospital-South Devon Healthcare NHS Foundation Trust, Torquay, United Kingdom.
Retin Cases Brief Rep. 2019;13(3):269-272. doi: 10.1097/ICB.0000000000000577.
To report ocular side effects after inadvertent intracameral injection of a high dose of cefuroxime.
Nineteen eyes of 19 patients were seen in our eye department 1 week after the referring surgeon had injected an erroneous dose of intracameral cefuroxime (12.5 mg/0.1 mL in 14 patients, Group A, and 10 mg/0.1 mL in 5 patients, Group B) at the end of a cataract surgery. A complete ophthalmic examination was performed postoperatively.
Eight patients (42.10%) exhibited ocular side effects. One patient (Group A) developed a noninfectious panuveitis. One case (Group B) had a serous macular detachment. Five patients (4 from Group A and 1 from Group B) showed a disruption of the ellipsoid layer with temporary/permanent drop in visual acuity. One patient presented with color alteration (Group A), but electrodiagnostic studies did not reveal any significant alterations.
Anterior and posterior inflammation has been described after intracameral injection of high dose of cefuroxime. In this study, 10 mg to 12.5 mg of intracameral cefuroxime is shown to be, principally, toxic to the retina with transient or permanent retinal changes on optical coherence tomography which correlate with visual outcomes postoperatively. Protocols to avoid dilution errors should be available in theaters during cataract surgery where such commercial preparations are not available.
报告意外前房内注射高剂量头孢呋辛后的眼部副作用。
19例患者的19只眼在转诊外科医生于白内障手术结束时错误注射前房内头孢呋辛（14例患者为12.5mg/0.1mL，A组；5例患者为10mg/0.1mL，B组）1周后在我们眼科就诊。术后进行了全面的眼科检查。
8例患者（42.10%）出现眼部副作用。1例患者（A组）发生非感染性全葡萄膜炎。1例（B组）出现浆液性黄斑脱离。5例患者（A组4例，B组l例）出现椭圆体层破坏，视力暂时/永久性下降。1例患者出现颜色改变（A组），但电诊断研究未发现任何明显改变。
已有报道前房内注射高剂量头孢呋辛后出现前部和后部炎症。在本研究中，10mg至12.5mg的前房内头孢呋辛主要对视网膜有毒性，光学相干断层扫描显示视网膜有短暂或永久性变化，这与术后视力结果相关。在没有此类商业制剂的白内障手术过程中，手术室应制定避免稀释错误的方案。
