Prophylactic intracameral cefuroxime -: Evaluation of safety and kinetics in cataract surgery
Prophylactic intracameral cefuroxime -: Evaluation of safety and kinetics in cataract surgery
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DOI：
10.1016/s0886-3350(01)01270-6
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发表时间：
2002-06-01
影响因子：
2.8
通讯作者：
Zetterström, C
中科院分区：
文献类型：
--
作者：
Montan, PG;Wejde, G;Zetterström, C
目的：评估白内障手术中预防性前房内注射头孢呋辛的安全性和动力学。瑞典斯德哥尔摩圣埃里克斯医院眼科。方法：在一项非随机观察者蒙蔽最佳案例试验中，评估了 45 名接受前房内注射头孢呋辛的患者和 45 名对照患者白内障手术后的视力康复情况以及激光耀斑强度和角膜内皮细胞密度的变化。在一项包括 1997 年接受手术的所有白内障患者的筛查计划中，使用皮肤点刺试验评估了免疫球蛋白 E 介导的对头孢呋辛的敏感性。术后 30 秒 (n = 10) 和 1 小时 (n = 9) 采集的样本中头孢呋辛的前房内浓度通过微生物检测以观察者掩蔽的方式进行了评估。 结果：前房内注射头孢呋辛对与不给予前房内抗生素预防相比，术后视力、诱导激光耀斑强度或内皮细胞损失。在 5813 名白内障筛查患者中，发现 3 例头孢呋辛皮肤点刺试验呈阳性。 30秒时头孢呋辛的中位房水浓度为2742 mg/L，滴注1小时后降至756 mg/L。结论：就局部毒性而言，前房内注射头孢呋辛1 mg是安全的。免疫球蛋白 E 介导的头孢呋辛过敏在白内障人群中很少见。即使在手术后 1 小时，治疗也达到了高水浓度。 (C) 2002 ASCRS 和 ESCRS。
Purpose: To evaluate the safety and kinetics of prophylactic intracameral cefuroxime in cataract surgery.Setting. Department of Ophthalmology, St. Eriks Hospital, Stockholm, Sweden.Methods: In a nonrandomized observer-masked best-case trial, the visual rehabilitation and the evolution of laser flare intensity and corneal endothelial cell density after cataract surgery were assessed in 45 patients receiving intracameral cefuroxime and in 45 control patients. Immunoglobulin E-mediated sensitivity was evaluated using a skin prick test to cefuroxime in a screening program comprising all cataract patients operated on in 1997. Intracameral concentrations of cefuroxime in samples retrieved 30 seconds (n = 10) and 1 hour (n = 9) postoperatively were evaluated in an observer-masked fashion with a microbiological assay.Results: Intracameral cefuroxime did not have a statistically significant effect on postoperative visual acuity, induced laser flare intensity, or endothelial cell loss compared with nonadministration of intracameral antibiotic prophylaxis. Three positive skin prick tests to cefuroxime were found in the 5813 screened cataract patients. The median aqueous humor concentration of cefuroxime at 30 seconds was 2742 mg/L, declining to 756 mg/L 1 hour after drug instillation.Conclusions: Intracameral cefuroxime 1 mg appears safe in terms of local toxicity. Immunoglobulin E-mediated allergy to cefuroxime is rare in the cataract population. The treatment achieved high aqueous concentrations even 1 hour after surgery. (C) 2002 ASCRS and ESCRS.