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I. A. Cochereau, S. Giraudet, C. Lamirel, C. Rabaute, S. Cornu, J. Ebran, G. Jallet; Corneal and Retinal Tolerance of Intracameral Cefuroxime in Phacoemulsification. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2677.
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The efficacy of prophylactic intracameral cefuroxime in cataract surgery has been clinically demonstrated, but few objective data about its tolerance are available. We assessed the corneal and retinal tolerance of 1 mg of cefuroxime injected into the anterior chamber after phacoemulsification.
Comparative study of two successive groups of patients operated in a single center before and after the systematic use of intracameral cefuroxime as antibioprophylaxis. The first group G1 of 128 patients did not receive intracameral cefuroxime, the second group G2 of 128 patients received 1 mg of cefuroxime in 0.1 ml injected into the anterior chamber at the end of phacoemulsification + IOL implantation. Corneal endothelial cells count assessed by specular microscopy, macular thickness assessed by OCT and best-corrected visual acuity (BCVA) were recorded before and one month after surgery.
G1 and G2 groups were similar for age (73.3 vs 73.9 years), sex ratio W/M (1.5 vs 1.6), rate of right eye (65 vs 66%) and duration of ultrasounds (1.97 vs 1.99 mn), respectively. At one month, the average endothelial cells loss was 32% in G1 and 26% in G2. This high endothelial loss in both groups might be related to the maturity of cataracts with a mean pre-operative BCVA of 20/63 in G1 and 20/50 in G2. The average macular thickness was increased by 7.6 % in both groups. No difference in the increase of BCVA was found.
Intracameral cefuroxime injected at the end of the procedure did not induce a statistically significant effect on post-operative endothelial loss, macular thickness and visual acuity recovery when compared with no injection. The good objective tolerance of intracameral cefuroxime allows to consider its wide use as antibioprophylaxis in phacoemulsification.
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