Posttrabeculectomy anterior subcapsular cataract formation induced by anterior chamber air

We retrospectively examined the effect of air, as contrasted with balanced salt solution (BSS), sodium hyaluronate, or no substance at all, used to reform the anterior chamber at the end of trabeculectomy on subsequent cataract formation in 141 consecutive patients (173 phakic eyes). The minimum follow up was 120 days. The use of air increased the incidence of anterior subcapsular cataract formation significantly. Also, the eyes that had a large air bubble on postoperative day 1 had a higher incidence of anterior subcapsular cataract than the eyes with less air on that day. We suggest that the toxicity to the lens of the oxygen in the air increased the incidence of anterior subcapsular cataract in the eyes in which air was used. We recommend that BSS or sodium hyaluronate be used instead of air to reform the anterior chamber following trabeculectomy.