Breakdown and reestablishment of blood-aqueous barrier with implant surgery

Preoperative and serial postoperative anterior chamber fluorophotometry was performed after oral administration of fluorescein sodium in patients undergoing extracapsular cataract extraction combined with intraocular lens implantation. In placebo-treated eyes, the blood-aqueous barrier was reestablished at three months after surgery. The administration of topical indomethacin before and after surgery markedly decreased aqueous fluorescein concentration, and the blood-aqueous barrier was reestablished within five weeks. Because all patients were given sub-Tenon's injection of steroids immediately after surgery and intensive topical steroid therapy postoperatively, the effect of topical indomethacin was additive to or synergistic with steroids. The addition of topical indomethacin caused a small but statistically significant increase in the postoperative intraocular pressure; this effect lasted nine weeks.