Hemorrhagic Retinal Infarction Due to Inadvertent Overdose of Cefuroxime in Cases of Complicated Cataract Surgery: Retrospective Case Series

Purpose To present 4 patients that developed hemorrhagic retinal infarction attributable to inadvertent overdose of cefuroxime after cataract surgery. Design Case series. Subjects and Methods Surgery in 4 patients was complicated—the posterior capsule was absent or torn—and anterior vitrectomy was p...

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Bibliographic Details
Published in:American journal of ophthalmology 2014-02, Vol.157 (2), p.421-425.e2
Main Authors: Ciftci, Sueleyman, Ciftci, Leyla, Da, Umut
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anterior Chamber - drug effects
Anti-Bacterial Agents - adverse effects
Cataract Extraction - adverse effects
Cataracts
Cefuroxime - adverse effects
Drug dosages
Drug Overdose - etiology
Eye surgery
Hemorrhage
Humans
Infarction - chemically induced
Lens Implantation, Intraocular
Male
Ophthalmology
Optic Atrophy - chemically induced
Patients
Photoreceptors
Posterior Capsular Rupture, Ocular - etiology
Retinal Hemorrhage - chemically induced
Retinal Vessels - drug effects
Retrospective Studies
Surgery
Vitrectomy
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Summary:Purpose To present 4 patients that developed hemorrhagic retinal infarction attributable to inadvertent overdose of cefuroxime after cataract surgery. Design Case series. Subjects and Methods Surgery in 4 patients was complicated—the posterior capsule was absent or torn—and anterior vitrectomy was performed. Cefuroxime was inadvertently injected at a dose higher than recommended in all 4 cases. Results Case 1 had hemorrhage in the central and inferior retinal regions, as well as optic atrophy. Case 2 had hemorrhage in the peripapillary and macular regions, as well as optic atrophy. Case 3 had hemorrhage in the peripapillary and inferior retinal regions, as well as macular pucker attributable to fibrovascular formation in the central retinal region. Case 4 had hemorrhage in the peripapillary, macular, and inferior retinal regions. The cefuroxime doses administered to the presented patients were much higher than reported in other cases and resulted in a higher concentration in the vitreous. Consequently, the severity of toxicity was much higher than in other reported cases of cefuroxime-induced toxicity. Conclusion In cases of intracameral cefuroxime overdose, hemorrhagic retinal infarction can develop after cataract surgery.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2013.10.018