Our Summary

This research paper is about a 60-year-old patient who had a tough time with cataract surgery. After the surgery, the patient was given a shot of a drug called cefuroxime directly into the front part of the eye. However, afterwards, the patient started to experience a decrease in vision. When the doctors checked, they found extensive bleeding and swelling in the retina and leakage in the blood vessels of the retina. Even though the patient was treated with strong medication, their vision got worse and the eye’s optic nerve started to shrink. The tests ruled out any infection or rheumatic disease. The conclusion was that the cefuroxime injection, given after a complicated cataract surgery, had caused a blockage in the blood flow to the retina, damaging it. The authors of the paper warn eye surgeons and their teams about the potential harm cefuroxime can cause to the retina, especially in complicated cases.

FAQs

  1. What are the potential complications of a cefuroxime injection during cataract surgery?
  2. How was the decrease in visual acuity treated after the complicated cataract surgery?
  3. What is the significance of disseminated capillary loss in fluorescein angiography?

Doctor’s Tip

A helpful tip a doctor might tell a patient about retinal surgery is to closely follow post-operative instructions, including taking any prescribed medications as directed and attending all follow-up appointments. It is important to report any changes in vision or symptoms to your doctor immediately, as early detection and treatment of any complications can help prevent long-term damage to the retina. Additionally, it is important to discuss any concerns or questions with your doctor before undergoing retinal surgery to ensure you have a clear understanding of the procedure and potential risks.

Suitable For

Patients who may be recommended for retinal surgery include those with retinal detachment, macular holes, diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, and other retinal vascular diseases. Additionally, patients with complications from previous eye surgeries, such as endophthalmitis or retinal toxicity, may also require retinal surgery. It is important for surgeons to carefully evaluate each patient’s individual case and determine the most appropriate course of treatment.

Timeline

Before retinal surgery:

  • Patient undergoes cataract surgery with cefuroxime injection into the anterior chamber
  • Patient experiences decrease in visual acuity after surgery
  • Extensive retinal hemorrhages and edema, as well as retinal vascular leakage, are detected with fluorescein angiography

After retinal surgery:

  • Patient’s visual acuity is counting fingers from 4 meters
  • Patient is treated with intravenous pulse and oral corticosteroids
  • Rheumatologic investigation is negative
  • At month 5, visual acuity is counting fingers from 1 meter
  • Disseminated capillary loss in fluorescein angiography is observed
  • Optic nerve atrophy is present despite corticosteroid treatment
  • Patient develops retinal infarction due to cefuroxime injection

Overall, the patient experiences a decline in visual acuity and retinal complications following retinal surgery, leading to the development of retinal infarction. It is important for surgeons and surgical staff to be aware of the possibility of retinal toxicity when using cefuroxime, especially in complicated cases.

What to Ask Your Doctor

  1. What are the potential risks and complications of retinal surgery?
  2. How long is the recovery process after retinal surgery?
  3. What can I expect in terms of visual outcomes after retinal surgery?
  4. Are there any alternative treatments to retinal surgery that I should consider?
  5. How experienced are you in performing retinal surgery?
  6. Will I need to undergo any additional tests or evaluations before the surgery?
  7. How will my vision be monitored after the surgery?
  8. What steps can I take to optimize the success of the surgery and minimize the risk of complications?
  9. What should I do if I experience any unusual symptoms or changes in my vision after the surgery?
  10. Are there any lifestyle changes or precautions I should take following retinal surgery?

Reference

Authors: Sül S, Karalezli A. Journal: Turk J Ophthalmol. 2018 Dec 27;48(6):317-319. doi: 10.4274/tjo.61580. PMID: 30605940