ESCRS - FPM05.12 - Changes In Macular Thickness After Cataract Surgery With Intracameral Off-Label Cefuroxime Compared To Cefuroxime Approved For Intraocular Use.

Changes In Macular Thickness After Cataract Surgery With Intracameral Off-Label Cefuroxime Compared To Cefuroxime Approved For Intraocular Use.

Published 2022 - 40th Congress of the ESCRS

Reference: FPM05.12 | Type: Free paper | DOI: 10.82333/tt0x-va32

Authors: Alejandra Herranz-Cabarcos* 1 , Rosa Pifarre-Benítez 2 , Pere Ortiz-Sagrista 3 , Olga Salas-Fando 4 , Zaida Vega-López 4 , Ana Martínez-Palmer 4

1Ophthalmology,Hospital de Sant Joan Despí Moisès Broggi,Barcelona,Spain, 2Surgical Area,Hospital de l'Esperança - Parc de Salut Mar,Barcelona,Spain, 3Pharmacy,Hospital de l'Esperança - Parc de Salut Mar,Barcelona,Spain, 4Ophthalmology,Hospital de l'Esperança - Parc de Salut Mar,Barcelona,Spain

Purpose

Administration of intraocular antibiotics after cataract surgery constitutes a widespread practice to prevent postoperative infections. Parenteral presentations are manipulated to make them suitable for intraocular use, as specifically marketed products are limited. This preparation process has been associated with altered concentration, osmolarity or pH, which may cause postoperative adverse effects such as macular edema.

Setting

Hospital de l’Esperança - Parc de Salut Mar, Barcelona, Spain.

Methods

Prospective, randomized, double-masked clinical trial with two lines of treatment. Patients with no history of ocular pathology and moderate cataract were included. The study group received treatment with off-label cefuroxime and the control group with Cefuroxime specifically marketed for intraocular use. Ocular coherence tomography was performed before surgery and 4 to 6 weeks after. Main results were foveal thickness in microns and presence of macular edema.

Results

 622 patients were included, of which 312 (62%) were women. Mean age was 74.8 years (SD 8.1). 545 patients successfully completed the study protocol. 23 (9%) presented postoperative macular edema (ME), from which 15 of these patients were treated with off-label Cefuroxime. The statistical relation between macular edema and antibiotic was not statistically significant  (p value = 0.1). Clinically significant macular edema was observed in 7 patients, from which 6 were treated with off-label Cefuroxime. This relation was statistically significant (p value = 0.03)

Conclusions

Despite no statistical relationship was observed between incidence of macular edema and off-label Cefuroxime, cases of macular edema tended to be more severe in this group of patients