Intraocular miotics and postoperative inflammation.
Sixty patients scheduled for planned extracapsular cataract extraction with intraocular lens (IOL) implantation were randomly assigned to receive acetylcholine chloride, carbachol, or balanced salt solution (BSS) immediately after IOL placement and at the end of the surgical case. As part of the postoperative evaluation, patients were examined at the first and eighth postoperative day with a Kowa FC-1000 laser flare and cell meter to assess objectively the amount of postoperative inflammation. At day one and day eight, the amount of cell and flare in the carbachol group was significantly greater than in the acetylcholine group or in the BSS control group. The acetylcholine group had significantly less flare than the BSS group at day one; yet there was no difference between the two groups at day eight, nor was there a significant difference in the amount of cells between day one and day eight. It is presumed that the prolonged miosis seen in the carbachol group delays the re-establishment of the blood-aqueous barrier after surgery, causing the inflammatory response.
Roberts
C W
CW
Cornell University Medical College, New York, New York 10021.
D000109:Acetylcholine / Q000008:administration & dosage / Q000009:adverse effects*; D002217:Carbachol / Q000008:administration & dosage / Q000009:adverse effects*; D002387:Cataract Extraction; D004311:Double-Blind Method; D009877:Endophthalmitis / Q000139:chemically induced*; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage; D007910:Lenses, Intraocular; D015877:Miosis / Q000139:chemically induced; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000139:chemically induced; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects
D007552:Isotonic Solutions; D009883:Ophthalmic Solutions; D002217:Carbachol; D000109:Acetylcholine