Aqueous flare intensity after phacoemulsification in patients with diabetes mellitus

Abstract

Purpose: To prospectively compare the postoperative blood-aqueous barrier breakdown induced by phacoemulsification and implantation of a heparin-surfacemodified poly(methyl methacrylate) intraocular lens in the capsular bag in eyes with different stages of diabetic retinopathy (DR) and a control group.Setting: St. Erik's Eye Hospital, Karolinska Institute, Stockholm, Sweden.Methods: Aqueous flare intensity was measured preoperatively and 1 day, 1 week, and 3 months postoperatively in 21 nondiabetic control patients (Group 1), 20 diabetic patients with no or mild-moderate non proliferative DR (Group 2), and 19 diabetic patients with advanced DR (moderate-severe, severe nonproliferative, and proliferative DR) who were divided into groups: without clinically significant macular edema (CSIVIE), 7 eyes (Group 3), and with CSNIE, 12 eyes (Group 4).Results: Before surgery, flare intensity in Group 4 was significantly higher than in Groups 1 and 2 (P < .05). Surgical trauma increased flare values 1 day postoperatively in all groups. One week after surgery, Groups 1 and 4 had flare intensity significantly higher than preoperatively (P < .05). Recovery of flare occurred 3 months postoperatively in all groups except Group 2, in which it occurred 1 week after surgery. One day postoperatively, only Group 4 had significantly higher flare than Group 1 (P < .05). One week and 3 months after surgery, Group 4 had significantly higher flare intensity than Groups 1 and 2 (P < .05). The duration of phacoemulsification in Groups 2 and 4 was significantly longer than in Group 1 (P < .05). Operating time was significantly longer than in Group 1 only in Group 4 (P < .05).Conclusion: Eyes with advanced stages of DR and with CSME had the highest flare intensity after cataract surgery.