title: Hemorrhagic retinal infarction due to inadvertent overdose of cefuroxime in cases of complicated cataract surgery: retrospective case series.
abstract: OBJECTIVE
  To present 4 patients that developed hemorrhagic retinal infarction attributable to inadvertent overdose of cefuroxime after cataract surgery.
  
  
  METHODS
  Case series.
  
  
  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.
  
  
  CONCLUSIONS
  In cases of intracameral cefuroxime overdose, hemorrhagic retinal infarction can develop after cataract surgery.
authors.affiliation: Department of Ophthalmology, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey. Electronic address: ciftci1977@hotmail.com.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Çiftçi
authors.affiliation: Department of Cardiology, Dicle University, School of Medicine, Diyarbakır, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Çiftçi
authors.affiliation: Department of Ophthalmology, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey.
authors.forename: Umut
authors.initials: U
authors.lastname: Dağ
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002387:Cataract Extraction / Q000009:adverse effects*; D002444:Cefuroxime / Q000009:adverse effects*; D062787:Drug Overdose / Q000209:etiology*; D006801:Humans; D007238:Infarction / Q000139:chemically induced*; D019654:Lens Implantation, Intraocular; D008297:Male; D009896:Optic Atrophy / Q000139:chemically induced; D057851:Posterior Capsular Rupture, Ocular / Q000209:etiology; D012166:Retinal Hemorrhage / Q000139:chemically induced*; D012171:Retinal Vessels / Q000187:drug effects*; D012189:Retrospective Studies; D014821:Vitrectomy
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime