Hemorrhagic retinal infarction due to inadvertent overdose of cefuroxime in cases of complicated cataract surgery: retrospective case series – Accepted Manuscript

Abstract: Purpose: To present 4 patients that developed hemorrhagic retinal infarction due to inadvertent overdose of cefuroxime after cataract surgery.Design: Case series.Materials and Methods: Surgery in 4 patients was complicated—the posterior capsule was absent or torn—and anterior vitrectomy was performed. Cefuroxime was inadvertently injected at a dose higher than recommended in all 4 cases.Results: Case 1 had hemorrhage in the central and inferior retinal regions, and optic atrophy. Case 2 had hemorrhage in the peripapillary and macular regions, and optic atrophy. Case 3 had hemorrhage in the peripapillary and inferior retinal regions, and macular pucker due to fibrovascular formation in central retinal region. Case 4 had hemorrhage in the peripapillary, macular, and inferior retinal regions. The cefuroxime doses administered to the presented patients were much higher than reported in other cases and resulted in a higher concentration in the vitreous. Consequently, the severity of toxicity was much higher than in other reported cases of cefuroxime-induced toxicity.Conclusion: In cases of intracameral cefuroxime overdose hemorrhagic retinal infarction can develop after cataract surgery.