Persistence of Inflammation After Uncomplicated Cataract Surgery: A 6-Month Laser Flare Photometry Analysis.

Abstract

To evaluate, by laser photometry, the persistency of anterior chamber flare after uneventful phacoemulsification in asymptomatic patients with no signs of inflammation on slit lamp examination. Seventy-five patients previously enrolled in a randomized clinical trial that evaluated inflammation after uneventful phacoemulsification in eyes treated with dexamethasone 0.1% ophthalmic suspension (group1) or bromfenac 0.09% ophthalmic solution (group2) for 2weeks. Anterior chamber inflammation was investigated by laser flare photometry. At 30days after surgery, laser flare showed persistently elevated values. For this reason, patients were further analyzed at 3 and 6months. Additionally, optical coherence tomography was used to measure the central macular thickness (CMT) and to assess for postoperative pseudophakic macular edema. When compared to preoperative values, laser flare photometry demonstrated persistent ocular inflammation at postoperative days90 and 180 in group1, but not in group2. Laser flare values showed a significant reduction in group2 compared to group1 throughout all the follow-up (p < 0.001). The increase in mean CMT at days90 and 180 with respect to baseline was statistically significant in group1 but not in group2, in which it decreased to levels similar to preoperative value. Group1 showed a higher increase in mean CMT compared to group2 throughout all the follow-up (p < 0.001). The proportion of patients that developed pseudophakic cystoid macular edema (CME) was 14% (n = 5) and 0% (n = 0) in group1 and group2, respectively (p = 0.02). The bivariate analysis demonstrated a positive correlation between laser flare and CMT values in group1 but not in group2. Anterior chamber inflammation persists for more than 30days in a significant proportion of patients after uncomplicated cataract surgery and may be responsible for late onset of cystoid macular edema cases. ClinicalTrials.gov identifier, NCT03317847.