Postoperative inflammation: extracapsular cataract extraction versus phacoemulsification.
OBJECTIVE
To quantitatively compare postoperative inflammation after extracapsular cataract extraction (ECCE) with that after phacoemulsification in an Asian population.


METHODS
Singapore National Eye Center, Singapore.


METHODS
In this prospective, randomized, double-masked clinical trial, patients having cataract surgery were randomized to receive ECCE (n = 16) or phacoemulsification (n = 18). Diabetics were excluded. Two surgeons performed both types of surgery and implanted a 6.0 mm optic intraocular lens. Inflammation was assessed qualitatively by slitlamp grading of cells and flare and quantitatively using the Kowa flare meter. One independent postoperative investigator performed the slitlamp examination and laser flare meter readings.


RESULTS
The ECCE and phacoemulsification groups were comparable (P > .05) in age, sex, ethnicity, and preoperative flare levels. The combined slitlamp inflammatory scores (anterior chamber cells and flare) and mean laser flare meter readings showed the ECCE group had significantly higher mean flare measurements than the phacoemulsification group at days 4 (P = .0012), 8 (P = .0013), 15 (P = .0013), 30 (P = .0004), and 60 (P = .0164). Flare levels in the ECCE group returned to preoperative values by the second month; the phacoemulsification group achieved preoperative levels by 1 month. The clinical inflammatory assessment score correlated closely to the flare level readings.


CONCLUSIONS
Phacoemulsification induced less inflammation than ECCE, with the difference most marked in the first month after surgery.
Chee
S P
SP
Singapore National Eye Centre, Singapore.
Ti
S E
SE
Sivakumar
M
M
Tan
D T
DT
D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications; D011446:Prospective Studies; D014606:Uveitis, Anterior / Q000209:etiology*