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Application of cefuroxime during cataract surgery and its impact on macular thickness

Poster Details

First Author: P.Bulir CZECH REPUBLIC

Co Author(s):    V. Kasajova              

Abstract Details



Purpose:

OCT measurement of macular thickness before and one week after cataract surgery without cefuroxim application (GROUP1) and with cefuroxim application (GROUP2)

Setting:

Ophthalmology department, Hospital Liberec, Czech Republic

Methods:

In prospective study 20eyes in each group were analyzed. Patients with complicated cataract procedure, macular disease, glaucoma and other conditions having impact on RNFL thickness were excluded from this study. Mean of age by GROUP1 was 68 (+/- 14). Mean of age by GROUP2 73 (+/- 6) years. Parafoveolar (3mm) and perifoveolar (5mm) thickness in 4 sectors was measured by OCT-Optovue just before surgery and one week after surgery. 20 eyes underwent cataract procedure without intracameral cefuroxim application and 20 eyes underwent procedure with intracameral 1mg (0.1ml) cefuroxim application at the end of cataract surgery. Surgeries were performed by the same surgeon, clear cornea incision 2.2mm, hydrophobic acrylic IOL was implanted. Students paired t-test a unpaired t-test was used for statistically analysis.

Results:

There was significant increase of macular thickness by GROUP1 and GROUP 2 one week after surgery. Mean thickness of GROUP1 preoperatively was: parafovea 310µm (SD:14, n=20) perifovea 282µm (SD:16, n=20), postoperatively parafovea: 313µm (SD:15, n=20) perifovea: 285µm (SD:17, n=20) Difference of means is statistically significant (p=0.002), Mean thickness by GROUP2 preoperatively was parafovea 305µm (SD:10, n=20) perifovea 278µm (SD:11, n=20), postoperatively parafovea: 308µm (SD:11, n=20) perifovea: 281µm (SD:12, n=20)Difference of means is statistically significant (p=0.001) Means of change of macular thickness of prarafovea comparing GROUP1 and GROUP2 was 13µm resp. 14µm perifovea 10µm resp 13µm. Differences are not statistically significant (p=0.4 resp 0.5).

Conclusions:

Cefuroxim intracameral application based on the ESCRS study of prophylaxis of postoperative endophthalmitis study became „gold standard' of endophthtalmitis prevention after cataract surgery. The aim of our study was to prove that cefuroxim intracameral aplication has no toxic effect on retina causing increased edema compare to cataract surgery without intracameral application. It has been proved by studies that phacoemulisification has impact on macular thickness measured by OCT. Results showed that there is no significant difference of postoperative macular thickness increase in group with or without cefuroxim. Based on results authors believe that intracameral cefuroxim application has no (toxic) impact on macula and retina. FINANCIAL INTEREST: NONE

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