Postoperative inflammatory response to phacoemulsification and implantation of 2 types of foldable intraocular lenses in pseudoexfoliation syndrome

Abstract

Patients with pseudoexfoliation syndrome (PEX) are known to have a greater degree of inflammation after cataract surgery when compared to patients with senile cataract in otherwise healthy eyes. We performed a randomised, prospective study to compare the influence of the intra-ocular lens (IOL) material of two different IOLs on the postoperative inflammation of the anterior chamber. 28 eyes of 27 patients with PEX and cataract and 29 eyes of 29 control patients were included in this study. The IOLs used were the hydrophilic, acrylic lens: Bausch&Lomb-Hydroview and the hydrophobic, acrylic Alcon Acrysof MA60 lens. The patients were examined preoperatively as well as on day 1, 3, 7 and 1, 3, and 6 months after surgery using the Laser flare-cell meter (LFCM) KOWA FC 1000. The preoperative flare and cell values were significantly higher in PEX eyes as compared to the control group. The values decreased after about 1 month to reach values comparable to those in the control group. Over the six months period there was no significant difference between the values of both lenses in the PEX group except on the first postoperative day where the flare and cell values were higher in the Acrysof-lens group. When comparing both groups with the Hydroview-lens there was also no significant difference, except on day 7, between the PEX group and the control group up to 6 months after surgery. When comparing both groups with the Acrysof-lens, there was a significant difference between the PEX group and the control group until 1 month after surgery. Although PEX-eyes had higher flare and cell values up to one month after surgery, we could not determine a significant difference, except on the first postoperative day, between both IOLs. A significant difference was evident between the PEX and control group in eyes with an Acrysof-lens. Using this clinical model, the LFCM highlights only certain aspects of biocompatibility of different lens types.