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

• Published in: American journal of ophthalmology Vol. 157; no. 2; pp. 421 - 425.e2
• Main Authors: Ciftci, Sueleyman, Ciftci, Leyla, Da, Umut
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2014; Elsevier Limited
• 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
• ISSN: 0002-9394; 1879-1891; 1879-1891
• DOI: 10.1016/j.ajo.2013.10.018

To present 4 patients that developed hemorrhagic retinal infarction attributable to inadvertent overdose of cefuroxime after cataract surgery. Case series. 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. 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. In cases of intracameral cefuroxime overdose, hemorrhagic retinal infarction can develop after cataract surgery.