[Blood-aqueous barrier after phacoemulsification with posterior chamber lens implantation; foldable acrylate lens vs PMMA lens-- a clinical study on 46 eyes].
BACKGROUND
Cataract surgery leads to a more or less pronounced postoperative inflammation due to breakdown of the blood-aqueous barrier. This alteration of the blood-aqueous barrier can be reduced by minimally invasive surgery. The purpose of this study was to quantify the early course of the postoperative alteration of the blood-aqueous barrier following phacoemulsification with implantation of conventional PMMA posterior chamber lens (IOL) in comparison with foldable acrylic lens implantation.


METHODS
Forty-six eyes of 46 patients (age 63 +/- 8.8 years) without preexisting deficiences of the blood-aqueous-barrier or previous intraocular surgeries were divided into two groups: group 1 (24 patients): phacoemulsification with one-piece-PMMA-IOL implantation (6.5 mm corneoscleral tunnel incision); group 2 (22 patients): phacoemulsification with foldable acrylic-IOL implantation (3.5 mm incision, 15 patients with corneoscleral tunnel and 7 patients with clear cornea incision). All surgical procedures were performed by one surgeon. The postoperative treatment was standardized. Alteration of the blood-aqueous barrier was quantified by the laser flare-cell meter (Kowa, FC-1000) preoperatively and on the first and the second day after surgery.


RESULTS
Preoperative aqueous flare values (photon counts/ms) were comparable in both groups (6.7 +/- 2.7 versus 5.6 +/- 2.7 respectively, p = 0.1). On day 1, aqueous flare in group 1 (9.7 +/- 2.9) was not statistically significantly higher than in group 2 (9.2 +/- 2.2, p = 0.2) and remained relatively constant on day 2 after surgery (9.3 +/- 3.3), whereas the aqueous flare values in group 2 decreased statistically significant (6.7 +/- 2.3, p = 0.01). Postoperatively, there was no statistically significant difference of aqueous flare values between eyes with corneoscleral tunnel incision and eyes with clear corneal incision (p = 0.7) in group 2.


CONCLUSIONS
Our study shows that phacoemulsification with foldable IOL implantation leads to a mild and short-lasting alteration of the blood-aqueous barrier. Thus, implantation of foldable IOL may be useful in eyes especially with preexisting alteration of the blood-aqueous-barrier.
Nguyen
N X
NX
Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg.
Tomida
I
I
Küchle
M
M
D000179:Acrylates; D000368:Aged; D001082:Aqueous Humor; D018916:Blood-Aqueous Barrier; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects* / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome
D000179:Acrylates