Effect of Intracameral Ophthalmic Cefuroxime Solution (Aprokam(®)) in the Prophylaxis of Cataract Surgery in Patients with Keratoplasty

BACKGROUND: Development of endophthalmitis during cataract surgery is one of the most severe complications and it may also result in blindness and globe loss. AIMS: To evaluate the effect of an ophthalmic cefuroxime solution (Aprokam(®)) that is prophylactically used in phacoemulsification surgery performed due to cataract that eventually occurs in patients with or without penetrating keratoplasty. STUDY DESIGN: Case-control study. METHODS: In this retrospective study, patients who had undergone penetrating keratoplasty and for whom phacoemulsification surgery was performed due to cataract and an intracameral ophthalmic cefuroxime solution (Aprokam(®)) was administered for prophylaxis were evaluated in comparison with patients with cataract without keratoplasty. The following parameters were evaluated: postoperative anterior chamber reaction, intraocular pressure, best corrected visual acuity, corneal endothelial cell density, and central corneal thickness alterations. RESULTS: A total of 42 patients (18 males, 24 females) with keratoplasty and 42 patients (17 males, 25 females) without keratoplasty were included in this study. An increase in visual acuity was observed in all the patients after cataract surgery (p<0.001). The mean corneal endothelial cell densitys were determined to be 2437.20±148.5 cells/mm(2) preoperatively in the study group and 2807.1±152.4 cells/mm(2) preoperatively in the control group. The mean corneal endothelial cell densitys were determined to be 2103.85±196.5 cells/mm(2) after the first postoperative month (p<0.001) in the study group and 2755.92±182.7 cells/mm(2) in the control group (p=0.17). The mean central corneal thickness in the study group were 565.78±11.5 μm preoperatively and 584.65±12.7 μm after the first postoperative month (p<0.001). No difference was observed in the control group in terms of preoperative and postoperative central corneal thickness and endothelial cell density. There was no significant difference between the groups in terms of the intraocular pressure, anterior chamber reaction. CONCLUSION: There was no significant effect of the prophylactic intracameral use of ophthalmic cefuroxime solution (Aprokam(®)) on the endothelial cells which was used in patients with keratoplasty for whom cataract surgery was performed.