Quantification of blood-aqueous barrier breakdown after phacoemulsification in Fuchs' heterochromic uveitis.
OBJECTIVE
To quantify the breakdown of the blood-aqueous barrier (BAB) following phacoemulsification with posterior chamber lens implantation in eyes with Fuchs' heterochromic uveitis (FHU).


METHODS
In this retrospective study, 19 eyes of 19 patients with FHU (mean age 38 +/- 14 years) and 35 eyes of 35 patients with senile cataracts (mean age 63 +/- 9 years) underwent phacoemulsification with one-piece PMMA posterior chamber lens implantation. Aqueous flare was quantified using the laser flare-cell meter (LFCM, Kowa FC-1000) following medical pupillary dilation preoperatively and 1, 3, and 5 days, then 1 and 6 weeks and 6 months postoperatively.


RESULTS
Mean preoperative aqueous flare (in photon counts per millisecond) in FHU vs. controls was 11.7 +/- 3.5 vs. 5.8 +/- 1.7. Following cataract surgery, mean aqueous flare increased to 27.8 +/- 4.4 vs. 16.0 +/- 4.5 on day 1, decreased to 23.6 +/- 4.0 vs. 11.8 +/- 3.5 on day 3, and to 18.0 +/- 3.0 vs. 9.5 +/- 1.7 on day 5. In FHU eyes, it was 13.9 +/- 2.7 after 1 week, and had returned to preoperative levels after 6 weeks (10.9 +/- 2.5) and remained stable for up to 6 months (mean 10.3 +/- 2.2). Pre- and postoperatively, aqueous flare values were 2-3 times higher in FHU eyes than in control eyes with senile cataract (p = 0.01). No postoperative complications such as fibrin formation, synechiae, macrophages on the intraocular lens optic or endophthalmitis were observed in any of the patients.


CONCLUSIONS
BAB breakdown following phacoemulsification with posterior chamber lens implantation is relatively mild in eyes with FHU and the BAB appears to be fully reestablished to preoperative levels 6 weeks postoperatively, explaining the usually good outcome of cataract surgery in this condition.
Nguyen
Nhung X
NX
Department of Ophthalmology and University Eye Hospital, University of Erlangen-Nurnberg, Erlangen, Germany. nhung.nguyen@augen.imed.uni-erlangen.de
Kuchle
Michael
M
Naumann
Gottfried O H
GO
D000328:Adult; D001082:Aqueous Humor / Q000166:cytology*; D018916:Blood-Aqueous Barrier; D002199:Capillary Permeability; D002386:Cataract / Q000150:complications; D005260:Female; D015590:Fluorophotometry; D006801:Humans; D015863:Iridocyclitis / Q000150:complications*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D012189:Retrospective Studies
D019904:Polymethyl Methacrylate