title: Heparin-modified lenses for eyes at risk for breakdown of the blood-aqueous barrier during cataract surgery.
abstract: To determine the appropriateness of heparin-surface-modified (HSM) lenses in eyes at risk for breakdown of the blood-aqueous barrier, 36 consecutive patients with cataracts associated with chronic recurrent or past uveitis had extracapsular cataract extraction and insertion of an HSM posterior chamber one-piece intraocular lens (IOL). Examinations for implant precipitates (IPs), fibrin membranes, IOL synechias, and visual outcome were done postoperatively. Results show that despite a recurrence of overt uveitis with keratic precipitates in 13 eyes (36.1%), IPs were seen in only six eyes (16.6%) and were generally small and few in number. An acute postoperative fibrin reaction, which is related to blood-aqueous barrier breakdown, occurred in nine eyes. Implant synechias were found in three eyes. We found that HSM provided a cell-free IOL surface in the majority of eyes at high risk for blood-aqueous barrier breakdown and uveitis. Heparin surface modification does not prevent complications but tends to protect the IOL from inflammation changes that might otherwise occur.
authors.affiliation: Ophthalmic Department, Scarborough Hospital, North Yorkshire, England.
authors.forename: S P
authors.initials: SP
authors.lastname: Percival
authors.forename: V
authors.initials: V
authors.lastname: Pai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001082:Aqueous Humor / Q000378:metabolism*; D001693:Biological Transport, Active; D001769:Blood / Q000378:metabolism*; D002386:Cataract / Q000150:complications / Q000378:metabolism; D002387:Cataract Extraction / Q000009:adverse effects*; D005260:Female; D006493:Heparin; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012307:Risk Factors; D014606:Uveitis, Anterior / Q000150:complications / Q000378:metabolism
chemical_list: D006493:Heparin