title: Transient macular edema after intracameral injection of a moderately elevated dose of cefuroxime during phacoemulsification surgery.
abstract: OBJECTIVE
  Intracameral injection of cefuroxime sodium (1 mg/0.1 mL) has been reported to reduce the risk of endophthalmitis following cataract surgery. In the United States it must be compounded, which is subject to dilution error. We describe a series of 13 eyes that received intracameral injection of cefuroxime sodium, 9 mg/0.1 mL, intraoperatively.
  
  
  METHODS
  On postoperative day 1, 6 of 13 eyes (46%; 95% CI, 19%-75%) had visual acuity of 20/70 or worse and macular edema. Spectral-domain optical coherence tomography of 2 eyes revealed central subfield thicknesses of 909 and 873 µm. On postoperative day 4, the mean (SD) central subfield thickness was 309 (78) µm in the 6 eyes with diagnosed macular edema, 279 (23) µm in the fellow eyes, and 271 (38) µm in the 7 exposed eyes without macular edema. The mean (SD) time to resolution of macular edema was 5.2 (1.3) days; the final central subfield thickness ranged from 193 to 293 µm. All eyes, except 2 with preexisting ocular comorbidity, had a best-corrected final visual acuity at 1 month of 20/30 or better. Significant corneal edema was not observed.
  
  
  CONCLUSIONS
  Intracameral injection of cefuroxime sodium at a dose of 9 mg/0.1 mL was associated with transient macular edema and diminished visual acuity in 6 of 13 exposed eyes (46%), resolving largely within 1 week.
authors.affiliation: Department of Ophthalmology, Kaiser Permanente, Fresno, California.
authors.forename: David C
authors.initials: DC
authors.lastname: Wong
authors.affiliation: Department of Ophthalmology, Kaiser Permanente, Fresno, California.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Waxman
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Herrinton
authors.affiliation: Department of Ophthalmology, Kaiser Permanente, Walnut Creek, California4Department of Quality, Kaiser Permanente, Walnut Creek, California.
authors.forename: Neal H
authors.initials: NH
authors.lastname: Shorstein
mesh_terms: D000867:Anterior Chamber / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002444:Cefuroxime / Q000008:administration & dosage / Q000009:adverse effects*; D004339:Drug Compounding / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D056965:Injections, Intraocular; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000139:chemically induced* / Q000175:diagnosis; D018918:Phacoemulsification; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime