Royal Eye Infirmary, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Royal Eye Infirmary, University Hospitals Plymouth NHS Trust, Plymouth, UK
BMJ Case Rep. 2022 May 26;15(5):e247772. doi: 10.1136/bcr-2021-247772.
We report a case of a white man in his 80s presenting with reduced vision, 1 day following uncomplicated cataract surgery. Optical coherence tomography scan showed evidence of a large collection of subretinal and intraretinal fluid. There was no ocular abnormality of note to explain these macular findings. The findings were presumed to be caused by cefuroxime toxicity despite a standard intraoperative dose of 1 mg/0.1 mL injected into the anterior chamber. We have postulated that the process of discarding excess cefuroxime onto the corneal wound or surface may inadvertently lead to a higher dose entering the eye than intended. This patient was treated with topical prednisolone 1%, ketorolac 0.5% and chloramphenicol 0.5% in place of the standard Maxitrol (dexamethasone 0.1% with neomycin) prescribed as a postoperative regimen in our unit. There was complete resolution of the retinal changes with restoration of normal vision at 3-week follow-up.
我们报告了一例 80 多岁白人男性患者，在白内障手术后 1 天出现视力下降。光学相干断层扫描显示存在大量视网膜下和视网膜内液体积聚。没有明显的眼部异常可以解释这些黄斑病变。尽管术中标准剂量为 1 毫克/0.1 毫升注入前房，但仍认为这些发现是由于头孢呋辛毒性引起的。我们推测，将多余的头孢呋辛丢弃到角膜伤口或表面上可能会无意中导致进入眼睛的剂量高于预期。该患者接受了局部泼尼松龙 1%、酮咯酸 0.5%和氯霉素 0.5%治疗，替代了我们科室规定的术后方案中的标准典必殊（含新霉素的地塞米松 0.1%）。在 3 周随访时，视网膜病变完全消退，视力恢复正常。
