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Germain Barreau, Loïc Bourmault, Juliette Delmas, Jean-Paul Adenis, Pierre-Yves Robert; Harmlessness of 1 mg cefuroxime intracameral injection at the end of cataract surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2548.
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Intracameral 1mg cefuroxime injection at the end of cataract surgery is included in the good practice in France and a lot of countries. Few studies have shown a macular toxicity for high doses of cefuroxime in particular in a case of dilution error for exemple. This study has the purpose to question if there is or not a macular toxicity with 1mg.
We propose a study on 18, of simple cataract operated, eyes : by phakoemulsification, with the same surgeon, without particular surgical complications, and no posterior capsule rupture. Only patients with medium cataract and a normal macula were included in the study. A time-domain macular OCT was pre-operatively made, and then at 7 and 30 post-operative days. The principal criterion of judgement was the central macular thickness at 30 post-operative days.
The average pre-operative central macular thickness was 209,11 +/- 29,44 microns (143-279), at 7 post-operative days the average was 214,44 +/- 28,42 microns (145-267), and at 30 post-operative days was 219,44 +/- 27,41 microns (145-253). The differences observed between the pre and post-operative values were not significant.
These results show that at a dose of 1 mg, as an intracameral injection, and without posterior capsular rupture, cefuroxime does not significativly increase the central macular thickness. A study with a larger pool of patients would certainly confirm what the actual clinical practice lets us foresee.
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