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Postoperative inflammatory response to phacoemulsification and extracapsular cataract surgery: aqueous flare and
M V Pande1, D J Spalton, M G Kerr-Muir
1Eye Department, St. Thomas Hospital, London, United Kingdom.
Purpose:
To compare the postoperative blood-aqueous barrier (BAB) breakdown induced by phacoemulsification with continuous curvilinear capsulorhexis (CCC) and by extracapsular cataract extraction (ECCE) with a linear capsulotomy.
Setting:
Cataract and Refractive Surgery Research Unit, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
Methods:
Anterior chamber flare and cells were measured preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively in two parallel groups of 31 consecutive cataractous eyes. In Group 1, one surgeon performed ECCE with a linear capsulotomy; in Group 2, a second surgeon performed divide and conquer phacoemulsification with CCC. The preoperative, intraoperative, and postoperative medication regimen was the same in both groups.
Results:
Group 2 eyes had significantly lower anterior chamber flare and cell measurements in the first postoperative month than Group 1 eyes (.01 < P < .00001).
Conclusions:
Phacoemulsification with CCC induced a less severe BAB breakdown than ECCE with a linear capsulotomy. Phacoemulsification with CCC may be preferable in high-risk eyes such as those with glaucoma, diabetes, or uveitis, which are prone to complications resulting from postoperative BAB breakdown.