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We report an unusual case of intracameral precipitation from using vancomycin and cefuroxime after a trabeculectomy surgery. To the best of our knowledge, this is the first such report.
A 55-year-old man underwent right trabeculectomy with a 10 mg/0.2 ml subconjunctival injection of 5-fluorouracil in the superior fornix before surgery, for uncontrolled primary open-angle glaucoma. He had intracameral Vancocin (vancomycin hydrochloride: 2 mg/0.1 ml of a balanced salt solution, ie, 20 mg/ml; Eli Lilly, Hampshire, UK) and a combination of 4 mg/ml Betnesol (betamethasone sodium phosphate; UCB Pharma, Berkshire, UK) and 125 mg/ml Zinacef (cefuroxime sodium; GlaxoSmithKline, Middlesex, UK) subconjunctivally at the inferior fornix at the end of surgery. On postoperative review 2 h later, a florid white precipitate was observed in the anterior chamber (AC). (figure 1A). During the next 48 h, the precipitate completely cleared (figure 1B …