International Ophthalmology

, Volume 35, Issue 1, pp 49–57 | Cite as

Evaluation of macular thickness changes after intracameral vancomycin in cataract surgery

  • Jose L. Pérez-Canales
  • Juan J. Pérez-Santonja
  • Ezequiel Campos-Mollo
Original Paper


The purpose of this study was to determine the effect of intracameral injection of vancomycin at the end of routine cataract surgery on macular thickness using spectral domain optical coherence tomography. This prospective comparative case series included sixty eyes of 42 patients undergoing cataract surgery. Eyes were divided into two groups: 30 eyes (Group 1) received an intracameral injection of vancomycin (1 mg/0.1 ml) at the end of surgery, and 30 eyes (Group 2) received an intracameral injection of cefuroxime (1 mg/0.1 ml). Visual acuity, average macular thickness, and retinal thickness in 9 Early Treatment Diabetic Retinopathy Study (ETDRS) sectors were measured at baseline, and 1 week, 1 month, and 3 months after surgery. There were no differences in age, gender, visual acuity, and preoperative macular thickness between groups. In Group 1, average macular thickness significantly increased 1 month after surgery compared with baseline (P = 0.000) and then stabilized. Retinal thickness significantly increased in most of the ETDRS map sectors at 1-month follow-up. In Group 2, there was a significant increase in average macular thickness 1 month after surgery compared with baseline (P = 0.037). Likewise, retinal thickness increased in most of the ETDRS subfields at 1 month. Postoperative retinal thickness values and best-corrected visual acuity were similar in both groups 1 week, 1 month, and 3 months after surgery. Intracameral injection of vancomycin at the end of cataract surgery showed comparable effects to cefuroxime in terms of macular thickness changes and visual acuity.


Intracameral injection Macular thickness Optical coherence tomography Vancomycin 



No financial support was received for this submission.

Conflict of interest

None of the authors has conflict of interest with the submission.


  1. 1.
    Taban M, Behrens A, Newcomb RL, Nobe MY, Saedi G, Sweet PM, McDonnell PJ (2005) Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol 123:613–620PubMedCrossRefGoogle Scholar
  2. 2.
    ESCRS Endophthalmitis Study Group (2007) Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg 33:978–988CrossRefGoogle Scholar
  3. 3.
    Zhanel GG, Calic D, Schweizer F, Zelenitsky S, Adam H, Lagace-Wiens PR, Rubinstein E, Gin AS, Hoban DJ, Karlowsky JA (2010) New lipoglycopeptides: a comparative review of dalbavancin, oritavancin and telavancin. Drugs 70:859–886PubMedCrossRefGoogle Scholar
  4. 4.
    Chang DF, Braga-Mele R, Mamalis N, Masket S, Miller KM, Nichamin LD, Packard RB, Packer M (2007) Prophylaxis of postoperative endophthalmitis after cataract surgery: results of the 2007 ASCRS member survey. J Cataract Refract Surg 33:1801–1805PubMedCrossRefGoogle Scholar
  5. 5.
    Barry P, Cordoves L, Gardner S. ESCRS Guidelines for Prevention and Treatment of Endophthalmitis Following Cataract Surgery: data, dilemmas and conclusions. Dublin, Ireland, European Society of Cataract and Refractive Surgeons (2013). Available at: Accessed 26 Apr 2014
  6. 6.
    Axer-Siegel R, Stiebel-Kalish H, Rosenblatt I, Strassmann E, Yassur Y, Weinberger D (1999) Cystoid macular edema after cataract surgery with intraocular vancomycin. Ophthalmology 106:1660–1664PubMedCrossRefGoogle Scholar
  7. 7.
    Early Treatment Diabetic Retinopathy Study Research Group (1991) Grading diabetic retinopathy from stereoscopic color fundus photographs–an extension of the modified Airlie House classification. ETDRS report number 10. Ophthalmology 98:786–806CrossRefGoogle Scholar
  8. 8.
    Baillif S, Roure-Sobas C, Le Duff F, Kodjikian L (2012) Aqueous humor contamination during phacoemulsification in a university teaching hospital. J Fr Ophtalmol 35:153–156PubMedCrossRefGoogle Scholar
  9. 9.
    Dickey JB, Thompson KD, Jay WM (1991) Anterior chamber aspirate cultures after uncomplicated cataract surgery. Am J Ophthalmol 112:278–282PubMedCrossRefGoogle Scholar
  10. 10.
    Villada JR, Vicente U, Javaloy J, Alio JL (2005) Severe anaphylactic reaction after intracameral antibiotic administration during cataract surgery. J Cataract Refract Surg 31:620–621PubMedCrossRefGoogle Scholar
  11. 11.
    Moisseiev E, Levinger E (2013) Anaphylactic reaction following intracameral cefuroxime injection during cataract surgery. J Cataract Refract Surg 39(9):1432–1434PubMedCrossRefGoogle Scholar
  12. 12.
    Yonekawa Y, Kim IK (2012) Pseudophakic cystoid macular edema. Curr Opin Ophthalmol 23(1):26–32PubMedCrossRefGoogle Scholar
  13. 13.
    Kim SJ, Bressler NM (2009) Optical coherence tomography and cataract surgery. Curr Opin Ophthalmol 20:46–51PubMedCrossRefGoogle Scholar
  14. 14.
    Antcliff RJ, Stanford MR, Chauhan DS, Graham EM, Spalton DJ, Shilling JS, Ffytche TJ, Marshall J (2000) Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis. Ophthalmology 107:593–599PubMedCrossRefGoogle Scholar
  15. 15.
    Ouyang Y, Keane PA, Sadda SR, Walsh AC (2010) Detection of cystoid macular edema with three-dimensional optical coherence tomography versus fluorescein angiography. Invest Ophthalmol Vis Sci 51:5213–5218PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Murakami T, Nishijima K, Akagi T, Uji A, Horii T, Ueda-Arakawa N, Muraoka Y, Yoshimura N (2012) Segmentational analysis of retinal thickness after vitrectomy in diabetic macular edema. Invest Ophthalmol Vis Sci 53:6668–6674PubMedCrossRefGoogle Scholar
  17. 17.
    Gupta MS, McKee HD, Saldana M, Stewart OG (2005) Macular thickness after cataract surgery with intracameral cefuroxime. J Cataract Refract Surg 31:1163–1166PubMedCrossRefGoogle Scholar
  18. 18.
    Delyfer MN, Rougier MB, Leoni S, Zhang Q, Dalbon F, Colin J, Korobelnik JF (2011) Ocular toxicity after intracameral injection of very high doses of cefuroxime during cataract surgery. J Cataract Refract Surg 37:271–278PubMedCrossRefGoogle Scholar
  19. 19.
    Ball JL, Barrett GD (2006) Prospective randomized controlled trial of the effect of intracameral vancomycin and gentamicin on macular retinal thickness and visual function following cataract surgery. J Cataract Refract Surg 32:789–794PubMedCrossRefGoogle Scholar
  20. 20.
    Lobo CL, Faria PM, Soares MA, Bernardes RC, Cunha-Vaz JG (2004) Macular alterations after small-incision cataract surgery. J Cataract Refract Surg 30:752–760PubMedCrossRefGoogle Scholar
  21. 21.
    Penha FM, Rodrigues EB, Maia M, Furlani BA, Regatieri C, Melo GB, Magalhães O Jr, Manzano R, Farah ME (2010) Retinal and ocular toxicity in ocular application of drugs and chemicals–part II: retinal toxicity of current and new drugs. Ophthalmic Res 44(4):205–224PubMedCrossRefGoogle Scholar
  22. 22.
    Trinkhaus-Randall V, Edelhauser HF, Leibowitz HM, Freddo TF (1998) Corneal structure and function. In: Leibowitz HM, WaringIII GO (eds) Corneal disorders; clinical diagnosis and management. WB Saunders, Philadelphia, pp 21–27Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Jose L. Pérez-Canales
    • 1
    • 2
  • Juan J. Pérez-Santonja
    • 2
    • 3
  • Ezequiel Campos-Mollo
    • 1
    • 3
  1. 1.Department of OphthalmologyHospital Virgen de los LiriosAlcoySpain
  2. 2.Department of OphthalmologyAlicante University General HospitalAlicanteSpain
  3. 3.Cornea UnitOftalVist GroupAlicanteSpain

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