[Transient maculopathy after intracameral injection of cefuroxime]

We report on two cases of transient maculopathy following uneventful cataract surgery with intracameral administration of cefuroxime. Both patients achieved a visual acuity of no more than 20/200 on day 1 after surgery. Optical coherence tomography revealed a neurosensory detachment of the retina with schisis-like alterations in the outer nuclear layer. These findings completely resolved within 6 days of treatment with prednisolone acetate and nepafenac eye drops, resulting in full visual recovery.Intracameral administration of antibiotics, in Europe as cefuroxime 1 mg/0.1 ml, is recommended for endophthalmitis prophylaxis at the end of cataract surgery. At the same time, an association appears to exist between the rare occurrence of specific maculopathies and the application of cefuroxime, particularly in cases of overdose, but also sporadically. Patients who have undergone pars plana or anterior vitrectomy apparently have an inherently higher risk of developing maculopathy. Transient cefuroxime maculopathy usually has a benign, self-limiting course. Cataract surgeons should be aware of this condition and avoid overdosing that otherwise safe and effective drug.