Effects of intraocular cefotaxime on the human corneal endothelium

Purpose: To ascertain whether 0.4 mL of cefotaxime 0.25% applied intracamer ally causes toxic alteration of the human corneal endothelium. Methods: In this prospective randomized masked study, 66 patients had catar act extraction using phacoemulsification, a frown incision, and implantatio n of a poly(methyl methacrylate) intraocular lens. This was followed by int raocular injection of 0.4 mL of cefotaxime 0.25% or balanced salt solution (BSS(R)). Contact specular microscopy and photography were performed preope ratively 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 d ays postoperatively, and 2560 +/- 495 cells/mm(2) 3 months postoperatively. The mean endothelial cell count in the BSS (control) group was 2657 +/- 41 3 cells/mm(2), 2475 +/- 384 cells/ mm(2), and 2486 +/- 427 cells/mm(2), res pectively. 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 applicat ion of a control substance. With its broad spectrum of antibiotic activity, cefotaxime might be an appropriate alternative to other intraocularly admi nistered antibiotics in anterior segment surgery for prophylaxis and manage ment of infection. J Cataract Refract Surg 2001; 27:250-255 (C) 2001 ASCRS and ESCRS.