Effect of intracameral injection of ceftazidime on corneal endothelium by specular microscope after uncomplicated phacoemulsification cataract surgery

Abstract

Loss of endothelial cells is inevitable after cataract surgery. Therefore, it is critical to protect the corneal endothelium during cataract surgery to reach good visual outcomes afterward. Maintenance of corneal clarity depends on the good function of healthy endothelial cells in addition to an intact pumping system intended to remove fluid from the corneal stoma. Our study aimed to assess changes in the corneal endothelium using specular microscopy, after intracameral injection of ceftazidime in uncomplicated phacoemulsification and compared with a placebo. The changes were measured preoperatively and 1 month postoperatively. Our prospective cohort study comprised 40 eyes from 35 patients diagnosed with cataract, all of whom underwent uncomplicated phacoemulsification for cataract extraction. Endothelial cell density significantly decreased postoperatively compared with preoperative values in both groups. Central thickness of the cornea, coefficient of variation, and visual acuity significantly increased postoperatively compared to preoperative values in both groups. Endothelial cell density showed a significant decrease postoperatively with a P value equal to 0.01 for group A (placebo group) and 0.02 for group B (ceftazidime group). Central thickness of the cornea, coefficient of variation, and visual acuity showed significant increases postoperatively with a P value equal to 0.026, 0.005, and 0.001 for group A and 0.001, 0.034, and 0.001 for group B, respectively. Ceftazidime can be considered safe for corneal endothelium when used intracamerally during phacoemulsification cataract surgery for prophylaxis of postoperative endophthalmitis.