Postoperative inflammatory response to phacoemulsification and extracapsular cataract surgery: aqueous flare and cells.
OBJECTIVE
To compare the postoperative blood-aqueous barrier (BAB) breakdown induced by phacoemulsification with continuous curvilinear capsulorhexis (CCC) and by extracapsular cataract extraction (ECCE) with a linear capsulotomy.


METHODS
Cataract and Refractive Surgery Research Unit, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.


METHODS
Anterior chamber flare and cells were measured preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively in two parallel groups of 31 consecutive cataractous eyes. In Group 1, one surgeon performed ECCE with a linear capsulotomy; in Group 2, a second surgeon performed divide and conquer phacoemulsification with CCC. The preoperative, intraoperative, and postoperative medication regimen was the same in both groups.


RESULTS
Group 2 eyes had significantly lower anterior chamber flare and cell measurements in the first postoperative month than Group 1 eyes (.01 < P < .00001).


CONCLUSIONS
Phacoemulsification with CCC induced a less severe BAB breakdown than ECCE with a linear capsulotomy. Phacoemulsification with CCC may be preferable in high-risk eyes such as those with glaucoma, diabetes, or uveitis, which are prone to complications resulting from postoperative BAB breakdown.
Pande
M V
MV
Eye Department, St. Thomas Hospital, London, United Kingdom.
Spalton
D J
DJ
Kerr-Muir
M G
MG
Marshall
J
J
D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000276:immunology / Q000473:pathology*; D001082:Aqueous Humor / Q000166:cytology / Q000276:immunology*; D018916:Blood-Aqueous Barrier; D002199:Capillary Permeability; D002387:Cataract Extraction / Q000009:adverse effects; D002452:Cell Count; D009877:Endophthalmitis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications