intracamerally

Intracamerally refers to administration into the anterior chamber of the eye, the fluid-filled space between the cornea and the iris. In ophthalmology, intracameral injections are used to deliver medications directly to the intraocular environment during eye surgery or other procedures.

The most widely cited use is prophylaxis against postoperative endophthalmitis during cataract surgery, via intracameral antibiotics such as cefazolin or cefuroxime. Intracameral lidocaine is sometimes used for local anesthesia or to assist with pupil stability during surgery. In select cases, other agents, including preservative-free mydriatics or antifungal or antiviral solutions, may be employed, depending on the clinical context and institutional protocol.

Administration requires sterile technique and precise dosing, typically through the surgical incision or a dedicated paracentesis, with small-volume injections into the anterior chamber. Formulations should be preservative-free whenever possible; improper preparation or use of multi-dose products with preservatives can cause toxicity and inflammatory reactions such as toxic anterior segment syndrome (TASS). Operators must consider drug compatibility with ocular tissues and potential interactions with intraocular structures.

Risks include toxic anterior segment syndrome, endophthalmitis, fluctuations in intraocular pressure, and allergic or idiosyncratic reactions. The practice varies by region and institution, and guidelines emphasize careful validation of preparation, dosing, and patient selection. Intracameral therapy has contributed to lower postoperative infection rates but requires vigilance for adverse events and adherence to sterile technique and appropriate formulations.