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Chia-Yu Wang, Chun-Yao Cheng, Yi-Jie Peng; The Effect of Intracameral Cefuroxime after Routine Cataract Surgery on Macular Thickness and Perfusion Status. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2926 – F0079.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the safety of intracameral cefuroxime (ICI) 1mg/0.1ml at the end of routine phacoemulsification procedure, we designed a retrospective observational study to evaluate the early changes in retinal thickness (MRT), superficial capillary plexus (SCP) and deep capillary plexus (DCP) by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) after uncomplicated phacoemulsification.
27 eyes of 27 Asian adults were included: 13 eyes with ICI cefuroxime (CEF group) (67.5±12.7 years old); 14 eyes without ICI cefuroxime (Control) (69.93±8.32 years old). All subjects underwent a complete examination including best-corrected visual acuity (BCVA), slit lamp, fundoscope, OCT and OCTA scan before surgery (T0), 1 day (T1), 7 days (T7) and 30 days (T30) after surgery. The retinal thickness was defined as the average thickness in the central, inner and outer circle of the ETDRS grid. We exported OCTA images into ImageJ software (Figure 1). After subtracting the fovea avascular zone (FAZ), we made a 3mm diameter circle centered on the fovea to analyze vessel density (VD) and skeleton density (SD) of SCP and DCP respectively. Independent t test was used to compare parameters between two groups.
(Table 1) Before surgery, there was no significant difference of the mean VD and SD both in SCP and DCP between two groups. (Figure 2) At T1, the mean VD and SD in DCP increased significantly in CEF group compared to controls (29.63±3.24 % vs 25.93±2.30 %; P=0.003 and 8.15±0.91 % vs 7.40±0.64 %; P=0.025, respectively). At T30, the mean VD and SD in DCP elevated again in CEF group (29.89±2.99 % vs 27.73±2.56 %; P=0.054 and 8.11±0.75 % vs 7.52±0.54 %; P=0.026, respectively). Otherwise, there was no difference of mean BCVA, MRT and VD/SD in SCP between groups.
This study elucidates that VD and SD in DCP increase significantly at postoperative day 1 and day 30 in eyes with ICI cefuroxime after cataract surgery. Although the safety of prophylactic ICI cefuroxime is widely accepted nowadays, cefuroxime may still induce subclinical macular perfusion changes without affecting the postoperative visual acuity and macular thickness.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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