Effects of intraocular cefotaxime on the human corneal endothelium

Abstract

Purpose To ascertain whether 0.4 mL of cefotaxime 0.25% applied intracamerally causes toxic alteration of the human corneal endothelium. Methods In this prospective randomized masked study, 66 patients had cataract extraction using phacoemulsification, a frown incision, and implantation of a poly(methyl methacrylate) intraocular lens. This was followed by intraocular injection of 0.4 mL of cefotaxime 0.25% or balanced salt solution (BSS®). Contact specular microscopy and photography were performed preoperatively and 1 to 4 days and 3 months postoperatively. Results In the cefotaxime group, the mean endothelial cell count was 2729 cells/mm 2 ± 474 (SD) preoperatively, 2520 ± 462 cells/mm 2 1 to 4 days postoperatively, and 2560 ± 495 cells/mm 2 3 months postoperatively. The mean endothelial cell count in the BSS (control) group was 2657 ± 413 cells/mm 2, 2475 ± 384 cells/mm 2, and 2486 ± 427 cells/mm 2, respectively. There was no significant difference in cell count or morphology between groups ( P < .05). Conclusions Intraocular application of cefotaxime produced no significant changes in endothelial cell count or morphology when compared with application of a control substance. With its broad spectrum of antibiotic activity, cefotaxime might be an appropriate alternative to other intraocularly administered antibiotics in anterior segment surgery for prophylaxis and management of infection.