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Pupillary membrane following intracameral cefuroxime injection

Poster Details

First Author: E.Mata Diaz SPAIN

Co Author(s):    E. Conesa Hernandez   B. Jimenez-Rolando   A. Sanchez Ventosa   C. De Pablo Martin           

Abstract Details

Purpose:

To report a patient who developed a pupillary fibrinous membrane 24h after intracameral injection of cefuroxime at the end of uneventful cataract surgery.

Setting:

Ophthalmology department of Hospital Central de la Cruz Roja. Madrid.Spain

Methods:

A 81 year old woman was referred to our department for cataract surgery of the right eye. Medical history included hypertension, dyslipidemia and hypothyroidism which she managed medically. Ophthalmic history included high myopia and amblyopia of the left eye. The patient reported a cutaneous reaction after penicillin administration long time before but no known allergy to cefuroxime, which was well tolerated 6 months before in a cataract surgery of the left eye.

Results:

A pupillary membrane with fibrin tracts in the anterior chamber was observed 24 hours after uneventful phacoemulsification with intraocular lens implantation performed under topical anesthesia in the right eye. The condition resolved spontaneously on topical corticosteroids alone in 48h. No other cases of fibrinous reaction happened in other patients of the same surgical session, and the toxic anterior segment syndrome (TASS) was ruled out. We point out the differential clinical features of this case with TASS . We reviewed the literature for this kind of hypersensitivity reaction and found no reports.

Conclusions:

Cataract surgeons should be aware of the risk of hypersensitivity reactions to intracameral cefuroxime. Although cross reactivity between beta lactam and cephalosporin (cefuroxime) has a negligible risk as pointed out in the literature, intracameral cefuroxime should not be used in beta lactam allergic patients for endophthalmitis prophylaxis since there is a true risk of hypersensitivity reactions.

Financial Disclosure:

NONE

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