Drug-induced fatal aplastic anemia following cataract surgery

Aplastic anemia attributed to medications used in ophthalmology is rare. We report a fatal case that developed in a 73-year-old woman 7 weeks after cataract extraction performed under local anesthesia. Postoperative medications included a chloramphenicol-containing ointment, flurbiprofen sodium drops, prednisone acetate drops and orally given acetazolamide. It was felt that the aplastic anemia was related to therapy with chloramphenicol or acetazolamide or both. We recommend that the course of prophylactic antibacterial therapy after intraocular surgery be kept short, regardless of the preparation used. We urge caution in the choice and use of drugs known to be associated with aplastic anemia and recommend close monitoring of the hemogram.