ESCRS - PO106 - Cefuroxime Toxicity In Human Retinal Pigment Epithelial Cells － Implications For Preventing Endophthalmitis In Cataract Surgery

Cefuroxime Toxicity In Human Retinal Pigment Epithelial Cells － Implications For Preventing Endophthalmitis In Cataract Surgery

Published 2022 - 40th Congress of the ESCRS

Reference: PO106 | Type: ESCRS 2022 - Posters | DOI: 10.82333/sefy-e907

Authors: Mohamed Kamel* 1

1ophthamolgy,eye specialized hospital ,Cairo,Egypt

Purpose

Cefuroxime has been used to prevent postoperative endophthalmitis, commonly at the intracameral dose of 1 mg/mL at the end of cataract surgery. To elucidate possible retinal complications which were reported in the clinical setting, this study investigated cefuroxime toxicity in human retinal pigment epithelium (RPE) cells.

Setting

ophthalmogy department eye specialized hospital ain shams univeristy  caro egypt

Methods

Cultured human ARPE-19 cells were exposed to culture medium alone (control) or with cefuroxime (0.25, 0.75, 2.5, 7.5, 25, 75, or 250 mg/mL) for 1, 2, 6, or 24 hours. Cytoxicity was assessed by trypan blue staining, viability, TUNEL staining, propidium iodide/annexin V-FITC staining, caspase inhibition assay, and TEM

Results

On the trypan blue staining, exposure to 0.75 mg/mL cefuroxime for 24 hours resulted in dead and shrunken RPE cells; the numbers increased in a dose- and time-dependent manner. On the viability assay, exposure to 0.25 mg/mL cefuroxime for 24 hours or 25 mg/mL for 1 hour impaired the mitochondrial function.. On the propidium iodide/annexin V-FITC staining and flow cytometry, cefuroxime led to dose- and time-dependent cell death by both apoptosis and necrosis. Ultrastructural study showed that exposure to 2.5 mg/mL cefuroxime for 24 hours lead to swollen organelles, and higher concentrations induced remarkable swelling, disorganization of organelles, disruption of cell membranes, and cell lysis.

Conclusions

Cefuroxime causes time- and dose-dependent damage to RPE cells by apoptosis and necrosis. One of the apoptotic pathways is via caspase-2, mitochondria, and caspase-3. Ultrastructure and mitochondria function are impaired within 24 hours. Exposure to 2.5 mg/mL cefuroxime, the commonly used intracameral concentration, is detrimental to RPE cells. We recommend safety precautions to decrease the risk of RPE toxicity.