Aqueous flare intensity after phacoemulsification in patients with diabetes mellitus.
OBJECTIVE
To prospectively compare the postoperative blood-aqueous barrier breakdown induced by phacoemulsification and implantation of a heparin-surface-modified poly(methyl methacrylate) intraocular lens in the capsular bag in eyes with different stages of diabetic retinopathy (DR) and a control group.


METHODS
St. Erik's Eye Hospital, Karolinska Institute, Stockholm, Sweden.


METHODS
Aqueous flare intensity was measured preoperatively and 1 day, 1 week, and 3 months postoperatively in 21 nondiabetic control patients (Group 1), 20 diabetic patients with no or mild-moderate nonproliferative DR (Group 2), and 19 diabetic patients with advanced DR (moderate-severe, severe nonproliferative, and proliferative DR) who were divided into groups: without clinically significant macular edema (CSME), 7 eyes (Group 3), and with CSME, 12 eyes (Group 4).


RESULTS
Before surgery, flare intensity in Group 4 was significantly higher than in Groups 1 and 2 (P < .05). Surgical trauma increased flare values 1 day postoperatively in all groups. One week after surgery, Groups 1 and 4 had flare intensity significantly higher than preoperatively (P < .05). Recovery of flare occurred 3 months postoperatively in all groups except Group 2, in which it occurred 1 week after surgery. One day postoperatively, only Group 4 had significantly higher flare than Group 1 (P < .05). One week and 3 months after surgery, Group 4 had significantly higher flare intensity than Groups 1 and 2 (P < .05). The duration of phacoemulsification in Groups 2 and 4 was significantly longer than in Group 1 (P < .05). Operating time was significantly longer than in Group 1 only in Group 4 (P < .05).


CONCLUSIONS
Eyes with advanced stages of DR and with CSME had the highest flare intensity after cataract surgery.
Zaczek
A
A
St. Erik's Eye Hospital, Karolinska Institute, Stockholm, Sweden.
Zetterström
C
C
D000368:Aged; D000369:Aged, 80 and over; D001082:Aqueous Humor / Q000378:metabolism*; D018916:Blood-Aqueous Barrier; D020099:Coated Materials, Biocompatible; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000145:classification / Q000150:complications / Q000378:metabolism; D005260:Female; D006493:Heparin; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D008269:Macular Edema / Q000150:complications; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D019904:Polymethyl Methacrylate; D011446:Prospective Studies; D014606:Uveitis, Anterior / Q000209:etiology* / Q000378:metabolism
D020099:Coated Materials, Biocompatible; D006493:Heparin; D019904:Polymethyl Methacrylate