Serous retinal detachment after phacoemulsification with intracameral cefuroxime (a case-control report)

Abstract

Serous retinal detachment is a rare postoperative complication of phacoemulsification with intracameral antibiotics. Diagnostic and therapeutic strategy in such cases is not well known. Purpose: to present a case of serous retinal detachment after phacoemulsification with intracameral cefuroxime. Material and methods. A retrospective analysis of the medical record of one patient who had underwent cataract phacoemulsification on both eyes; the follow-up period was 5 months. Results. Phacoemulsification of noncomplicated cataract with implantation of intraocular lens in the right eye was completed uneventfully; 1 mg of cefuroxime was administered into the anterior chamber at the end of the surgery. In the first day after the surgery visual acuity decreased to 0.2. Serous detachment of retinal pigment and sensory epithelia in the macula area was revealed by optical coherence tomography (OCT). Fluorescein angiography showed no pathological vascular activity. The patient received standard post-surgery therapy supplemented with subtenon triamcinolone, intravenous dexamethasone injections and systemic acetazolamide ingestion. The retinal detachment status was monitored daily by OCT. By day 6 of the follow-up visual acuity recovered to 1.0. After 5 months, inner retinal profile deformation was revealed. The patient's left eye was considered the «control» eye; phacoemulsification without cefuroxime was performed on it 5 months after the initial surgery, and no complication occurred during the follow-up. Conclusion. Serous detachment of retinal pigment and sensory epithelia during the early postoperative period after cataract surgery may be caused by a toxic reaction to intracameral cefuroxime even when it's administered in standard dosage. This complication has a favorable prognosis, but requires long term monitoring.