Effects of intraocular cefotaxime on the human corneal endothelium.
OBJECTIVE
To ascertain whether 0.4 mL of cefotaxime 0.25% applied intracamerally causes toxic alteration of the human corneal endothelium.


METHODS
In this prospective randomized masked study, 66 patients had cataract extraction using phacoemulsification, a frown incision, and implantation of a poly(methyl methacrylate) intraocular lens. This was followed by intraocular injection of 0.4 mL of cefotaxime 0.25% or balanced salt solution (BSS(R)). Contact specular microscopy and photography were performed preoperatively and 1 to 4 days and 3 months postoperatively.


RESULTS
In the cefotaxime group, the mean endothelial cell count was 2729 cells/mm(2) +/- 474 (SD) preoperatively, 2520 +/- 462 cells/mm(2) 1 to 4 days postoperatively, and 2560 +/- 495 cells/mm(2) 3 months postoperatively. The mean endothelial cell count in the BSS (control) group was 2657 +/- 413 cells/mm(2), 2475 +/- 384 cells/mm(2), and 2486 +/- 427 cells/mm(2), respectively. There was no significant difference in cell count or morphology between groups (P <.05).


CONCLUSIONS
Intraocular application of cefotaxime produced no significant changes in endothelial cell count or morphology when compared with application of a control substance. With its broad spectrum of antibiotic activity, cefotaxime might be an appropriate alternative to other intraocularly administered antibiotics in anterior segment surgery for prophylaxis and management of infection.
Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany.
C
C
Kramann
S
S
Pitz
O
O
Schwenn
M
M
Haber
G
G
Hommel
N
N
Pfeiffer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000187:drug effects; D002439:Cefotaxime / Q000494:pharmacology*; D002452:Cell Count; D048429:Cell Size; D002511:Cephalosporins / Q000494:pharmacology*; D004311:Double-Blind Method; D009877:Endophthalmitis / Q000517:prevention & control; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies
D002511:Cephalosporins; D002439:Cefotaxime