Disruption of the blood-aqueous barrier by residual lens epithelial cells after intraocular lens implantation.
We performed a clinical study to confirm whether and how residual lens epithelial cells (LECs) participate in postoperative pseudophakic inflammation, including fibrin reaction. Twenty-six eyes of 13 patients with bilateral cataracts were treated by phacoemulsification and posterior chamber intraocular lens (PC-IOL) implantation. In the eye from which LECs had not been removed, the aqueous flare was measured with a laser flare-cell meter. Flare decreased from an initial peak, increasing again to form a flare spike when LECs came into contact with the PC-IOL and began to undergo fibrous proliferation at 6 to 14 days after surgery. The spike was evidence that the blood-aqueous barrier had been disrupted again. Fibrin reaction developed in two eyes. In the other eye of each pair, from which LECs had been removed by ultrasound aspiration, neither a flare spike nor fibrous proliferation was noted. We conclude that residual LECs break down the blood-aqueous barrier as they proliferate and are involved in postoperative pseudophakic inflammation.
Nishi
O
O
Nishi Eye Hospital, Osaka, Japan.
Nishi
K
K
D000328:Adult; D000368:Aged; D001082:Aqueous Humor / Q000378:metabolism*; D001693:Biological Transport, Active; D001769:Blood / Q000378:metabolism*; D002387:Cataract Extraction; D009877:Endophthalmitis / Q000209:etiology; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D007905:Lens Diseases / Q000150:complications; D007908:Lens, Crystalline / Q000473:pathology*; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications