Abstract
BackgroundTo evaluate the effectiveness and safety of hypothermic perfusion in the phacoemulsification of cataract caused by uveitis.MethodsThis was a prospective, single-masked, randomised, controlled clinical trial. One hundred and six patients with uveitis-associated cataract underwent phacoemulsification with perfusion fluid temperature at 4 °C (treatment group) or 24 °C (control group). Anterior chamber inflammation grade, corneal endothelial cell count, corneal thickness, macular fovea thickness, and intraocular pressure (IOP) were observed on the 1st day and 7th day after operation.ResultsThe aqueous flare score was 0.83 ± 0.76 in the 4 °C group, which was lower than that in the 24 °C group (1.51 ± 1.02, p = 0.006) on the first day after operation. The aqueous cells score was lower in the 4 °C group (0.17 ± 0.38) than that in the 24 °C group (0.62 ± 0.94, p = 0.025). The mean corneal thickness of incision in the 4 °C group (907.66 ± 85.37 μm) was thinner than that in the 24 °C group (963.75 ± 103.81 μm, p = 0.005). Corneal endothelial cells density, macular fovea thickness, or percentage of transiently increased IOP showed no difference between the two groups (p > 0.05). There was no significant difference in all the main outcome parameters between the two groups on the 7th day after operation (p > 0.05).ConclusionsHypothermic perfusion in the phacoemulsification of uveitis-associated cataract is safe, and it can effectively inhibit anterior chamber inflammation and reduce the incisional corneal edema in the early postoperative stage.Trial registrationThe study was registered with the Chinese Clinical Trial Registry. (http://www.chictr.org.cn/, Registration Number: ChiCTR1800016145).
Highlights
To evaluate the effectiveness and safety of hypothermic perfusion in the phacoemulsification of cataract caused by uveitis
We found that hypothermic perfusion in the phacoemulsification of senile hard nuclear cataract was safe and could effectively protect the corneal endothelium, decrease corneal edema and reduce anterior chamber inflammation in the early postoperative stage [13]
There were no statistical differences in gender, age, systemic anti-inflammatory medicine use, average phacoemulsification time, average ultrasound energy or perfusion time between the two groups (P > 0.05) (Table 1)
Summary
To evaluate the effectiveness and safety of hypothermic perfusion in the phacoemulsification of cataract caused by uveitis. Certain uveitis patients may complicate with cataract [1, 2]. Cataract in patients with uveitis results from both the process of primary disease and the persistent treatment with corticosteroids [2,3,4]. The ultrasound energy applied in phacoemulsification generate the heat, which may cause postoperative anterior chamber inflammation, corneal edema, incision burns, corneal endothelial cells loss, and even decompensation of corneal endothelium [3, 4]. The postoperative inflammatory reaction of cataracts caused by uveitis is usually more severe than that in senile cataracts because of the adhesive iris or intraocular environment prone to inflammation
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