We report a case of a white man in his 80s presenting with reduced vision, 1 day following uncomplicated cataract surgery. Optical coherence tomography scan showed evidence of a large collection of subretinal and intraretinal fluid. There was no ocular abnormality of note to explain these macular findings. The findings were presumed to be caused by cefuroxime toxicity despite a standard intraoperative dose of 1 mg/0.1 mL injected into the anterior chamber. We have postulated that the process of discarding excess cefuroxime onto the corneal wound or surface may inadvertently lead to a higher dose entering the eye than intended. This patient was treated with topical prednisolone 1%, ketorolac 0.5% and chloramphenicol 0.5% in place of the standard Maxitrol (dexamethasone 0.1% with neomycin) prescribed as a postoperative regimen in our unit. There was complete resolution of the retinal changes with restoration of normal vision at 3-week follow-up.
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Contributors WS was involved in planning, conduct, reporting, acquisition of data and writing of the initial draft of the case report. VR was involved in conception, conduct and interpreting data along with editing and proofreading the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.