[Effect of cataract technique and duration of surgery on fibrin reaction after IOL implantation].
BACKGROUND
Having changed our cataract operation technique from ECCE to phacoemulsification (PE) we had the impression of less fibrinous membranes postoperatively.


METHODS
To ascertain whether our impression was correct, we examined the last 2056 IOL implanted cataract patients retrospectively.


RESULTS
In the 2056 cataract cases we found 152 fibrinous reactions (7.4%). We observed after ECCE (n = 586) a 12.8% rate of fibrinous membranes, after phacoemulsification (PE) with sutured 6.5-mm corneoscleral incision (n = 546) 7.0%, and after PE with clear corneal self-sealing 4.1-mm incision (n = 924) only 3.9%. In 56% of these patients we found diabetes, in 13% former uveitis with posterior synechiae, in 11% glaucoma with rigid pupil, and in 10% pseudoexfoliation syndrome. In those cases with no diabetic retinopathy but known diabetes (n = 198), we found a 27% rate of fibrin reactions following ECCE (12 mm), 12% following PE (6.5 mm) and 8% following PE (4.1 mm). In non-proliferative diabetic retinopathy (n = 80) a 32% rate of fibrinous changes was observed after ECCE, 18% after PE (6.5 mm), and 9% after PE (4.1 mm). In cases of uncomplicated ECCE (n = 341) the rate of fibrinous reactions amounted to 22.4% following prolonged procedures (> 50 min) by residents, while it was as low as 9.5% following operations of short duration (< 30 min) by experienced surgeons. Intraocular injection of tPA (25 micrograms) was the most effective treatment.


CONCLUSIONS
The self-sealing corneal small incision cataract technique guarantees a short duration of the surgical procedure and the last fibrinous reactions.
Müller-Jensen
K
K
Augenklinik des Städtischen Klinikums Karlsruhe.
Rörig
M
M
Hägele
J
J
Zimmermann
H
H
D002387:Cataract Extraction / Q000379:methods*; D009877:Endophthalmitis / Q000503:physiopathology; D005337:Fibrin / Q000502:physiology*; D006801:Humans; D007910:Lenses, Intraocular; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications / Q000503:physiopathology*; D012189:Retrospective Studies
D005337:Fibrin