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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.

Purpose: To evaluate corneal endothelial changes after intracameral injection of vancomycin at the end of routine cataract surgery., Setting: Department of Ophthalmology, Hospital Virgen de los Lirios, Alcoy, Alicante, Spain., Design: Prospective comparative case series., Methods: Eyes received an intracameral injection of vancomycin (1 mg/0.1 mL) or cefuroxime (1 mg/0.1 mL) at the end of surgery. The visual acuity, corneal clarity, pachymetry, anterior chamber reaction, endothelial cell density (ECD), coefficient of variation (CoV), and hexagonality were evaluated at baseline and 1 week, 1 month, and 3 months after surgery., Results: Sixty eyes (42 patients), 30 in each group, were enrolled. In the vancomycin group, there was a significant decrease in ECD 1 week after surgery (P = .000), after which the ECD stabilized. There were no statistically significant changes in postoperative CoV values between preoperatively and postoperatively, although there was a transient decrease in hexagonality 1 week after surgery (P = .006). In the cefuroxime group, the ECD significantly decreased 1 week after surgery (P = .000) and then stabilized. There was a statistically significantly decrease in the CoV between preoperatively and 3 months postoperatively (P = .014). No changes were noted in hexagonality. The postoperative ECD, CoV, and hexagonality values were not significantly different between the vancomycin group and the cefuroxime group., Conclusions: Endothelial cell changes observed after intracameral vancomycin were similar to those observed after intracameral cefuroxime in cataract surgery. The results indicate that intracameral vancomycin is safe for use in cataract surgery., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)