SAFETY PROFILE OF INTRACAMERAL ANTIBIOTIC PROPHYLAXIS IN CATARACT SURGERY: RESULTS OF A COHORT STUDY

Objective – to compare the safety of intracameral endophthalmitis prevention after phacoemulsification compared to control group.
Material and methods. A comparative cohort study was conducted, with the main group receiving 1 mg of cefuroxime injected into the anterior chamber at the end of surgery, and the control group receiving no intracameral antibiotic prophylaxis.
Results. Clinical and functional outcomes did not differ between the two groups in terms of visual acuity levels at 1, 7, and 28 days after cataract phacoemulsification. Acute postoperative endophthalmitis was recorded in one patient in the main group (0.051%) and in eight patients in the control group (0.182%), with no statistically significant difference between the groups (p=0.4629). During 24 hours post-surgery, 7 patients in the main group were diagnosed with specific complications resulting from intracameral administration of cefuroxime. These complications manifested as serous retinal detachment with macular oedema, which accounted for 0.35% of cases. No such cases were found in the control group (p=0.0002). The condition was resolved within 7 days after standard topical anti-inflammatory therapy.
Conclusion. The present study reveals new findings regarding the safety of intracameral antibiotic prophylaxis in cataract surgery.

1. Neroev V.V., Malyugin B.E., Trubilin V.N., Zhudenkov K.V., Orlova O.M. Clinical and social burden of cataract treatment in Russia. Kataraktal''naja i refrakcionnaja hirurgija. 2016;16(1): 4- 14. (in Russ)

2. Svetozarskiy SN, Andreev AN, Shvaikin AV, Shcherbakova SV. Intraocular lens power in Russian population: distribution analysis. Vestnik Oftalmologii. 2020;136(3):100 105. (In Russ.)

3. Barry P. [et al.] ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery. Journal of Cataract & Refractive Surgery. 2006; 32(3): 407-410. (in Engl)

4. Bowen R.C. [et al.] Comparative analysis of the safety and efficacy of intracameral cefuroxime, moxifloxacin and vancomycin at the end of cataract surgery: a meta-analysis. Br. J. Ophthalmol. 2018;102(9):1268-1276. (in Engl)

5. Andreev AN, Svetozarskiy SN. Serous retinal detachment after phacoemulsification with intracameral cefuroxime (a case-control report). Vestnik Oftalmologii. 2018;134(3):73 77. (In Russ.)

6. Svetozarskiy SN, Andreev AN. Complications of intracameral cefuroxime in cataract surgery. Vestnik Oftalmologii. 2018;134(5):104 110. (In Russ.)

7. Svetozarskiy S.N., Andreev A.N., Shvaikin A.V. The incidence and the clinical course of retinal complications of intracameral cefuroxime in cataract surgery. Ophthalmology in Russia. 2022;19(4):782-788. (In Russ.)

8. Gurung R.L. Iatrogenic retinal detachment secondary to inadvertent subretinal injection during posterior sub-Tenon triamcinolone injection. GMS Ophthalmol. Cases. 2019; 9: Doc05. (in Engl)