Flare Values Research Articles

Effect of subconjunctival steroid injection on intraocular inflammation and blood glucose level after cataract surgery in diabetic patients

Purpose: To prospectively evaluate the usefulness of a subconjunctival steroid injection given at the completion of cataract surgery in patients with diabetes mellitus. Setting: University of Tokyo School of Medicine, Tokyo, Kaiya Eye Clinic, Hamamatsu, and Jyosai Hospital, Tokyo, Japan. Methods: One hundred four eyes of 104 diabetic patients having routine small incision cataract surgery were randomized into 2 groups. One group received a subconjunctival injection of dexamethasone and the other group did not. Aqueous flare intensity was measured with the laser flare meter preoperatively and 1, 2, 5, 7, and 14 days postoperatively. Another 19 diabetic patients having routine cataract surgery were randomized to receive a subconjunctival steroid injection or not; blood glucose concentration was measured 4 times a day for 3 days postoperatively. Results: There was no significant difference between the 2 groups in aqueous flare values at any postoperative time. The subconjunctival steroid injection induced a transient but significant increase in blood glucose on the day of surgery. Conclusion: A subconjunctival steroid injection given at the completion of cataract surgery in diabetic patients had no beneficial effects.

Randomized clinical trial of cryotherapy versus laser photocoagulation for retinopexy in conventional retinal detachment surgery

PURPOSE: To investigate whether the method of retinopexy influences the visual recovery rate and the breakdown of the blood-ocular barrier after conventional retinal detachment surgery. METHODS: Forty-eight patients (48 eyes) with primary rhegmatogenous retinal detachment entered into the study. All eyes were phakic, had an attached macula, and were scheduled for conventional scleral buckling surgery. Patients were randomly assigned to have either laser or cryotherapy for retinopexy. All visual acuity and flare measurements were performed by a masked observer. The interventional procedure was cryopexy at the time of scleral buckling surgery or postoperative (4 weeks) laser photocoagulation. Visual acuity testing with ETDRS chart and aqueous flare measurement with laser flare photometry were performed by a masked observer at standard intervals: preoperatively and 1 day, 7 days, 4 weeks, and 10 weeks postoperatively. Analysis of covariance by multiple linear regression was used for statistical evaluation. RESULTS: Postoperative flare values from patients receiving cryotherapy were significantly higher at each measurement point in time ( P ≤ .001). The visual recovery was slower in the patients receiving cryotherapy (1 week, P = .003; 4 weeks, P = .03; 10 weeks, P = .081). CONCLUSION: Laser flare photometry proved sufficiently sensitive to quantify an increase in aqueous flare after limited external retinal cryotherapy. Postoperative flare, as a measure of blood-ocular barrier breakdown, was significantly higher and visual recovery slower in the cryotherapy group. Visual acuity after 10 weeks was not significantly different between both groups.

Aqueous flare induced by heparin-surface-modified poly(methyl methacrylate) and acrylic lenses implanted through the same-size incision in patients with diabetes

Purpose To compare the degree of blood–aqueous barrier (BAB) breakdown in eyes of diabetic patients after phacoemulsification and implantation of heparin-surface-modified poly(methyl methacrylate) (PMMA) or soft hydrophobic acrylic intraocular lenses (IOLs) performed using the same technique with the same incision size to determine the influence of the IOLs on postoperative inflammation independent of other surgical factors. Settings Department of Ophthalmology, University of Paris XIII, Bobigny, France. Methods In a prospective study, 44 eyes of 31 diabetic patients with or without mild to moderate diabetic retinopathy were randomly assigned to receive an HSM PMMA IOL (22 eyes) or a soft hydrophobic acrylic IOL (22 eyes) after standardized phacoemulsification surgery. Both types of IOLs had a 6.0 mm optic, were inserted unfolded, and were placed in the bag through a calibered 6.0 mm superior scleral incision. Anterior chamber flare was measured preoperatively and 1, 7, 30, and 240 days postoperatively using the Kowa 500 laser flare meter. Results The mean flare value was higher on the first postoperative day in both groups. There were no statistically significant between-group differences in flare scores or clinical parameters preoperatively or at any postoperative visit. Conclusions No significant difference was observed in inflammation between eyes having HSM PMMA IOL implantation or those having soft hydrophobic acrylic IOL implantation through the same-size incision. This indicates that hydrophobic acrylic and HSM PMMA materials induce the same degree of BAB breakdown after phacoemulsification in eyes of diabetic patients.

Inflammation after phacoemulsification in diabetic retinopathy: Foldable acrylic versus heparin-surface-modified poly(methyl methacrylate) intraocular lenses

Purpose To evaluate inflammation after cataract surgery in patients with nonproliferative diabetic retinopathy (NPDR) and compare results with 2 intraocular lenses (IOLs): a foldable hydrophobic acrylic and a heparin-surface-modified (HSM) poly(methyl methacrylate) (PMMA). Setting Department of Ophthalmology, University of Vienna, Vienna, Austria. Methods Patients with NPDR were randomized for implantation of an HSM PMMA IOL (811C®, Pharmacia) through a 6.0 mm sclerocorneal incision (30 patients) or a foldable hydrophobic acrylic IOL (AcrySof®, Alcon) through a 4.0 mm sclerocorneal incision (32 patients). Both IOLs had 6.0 mm optics. All patients were treated according to a standardized protocol. The degree of flare in the anterior chamber was measured with the Kowa 1000 laser flare–cell meter 1 day preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. Results In both IOL groups, flare was highest on the first postoperative day and decreased to preoperative levels by 3 months after surgery. There was no statistically significant difference in relative flare values between the 2 groups. Conclusion There was no difference in postoperative inflammation in eyes with a foldable hydrophobic acrylic IOL implanted through a small incision and those with a rigid HSM PMMA IOL. Postoperative inflammation results indicate that the lenses are equally suitable for the use in patients with diabetic retinopathy.

Disruption of the Blood-Aqueous Barrier following Retinal Laser Photocoagulation and Cryopexy in Pigmented Rabbits

Disruption of the blood-aqueous barrier (BAB) induced by retinal photocoagulation and cryopexy in pigmented rabbits was evaluated by laser flare photometry. A significant increase in flare values after retinal photocoagulation was measured from the 1st postoperative day, with values returning to baseline levels by day 7. Cryopexy induced consistently high flare values for 14 days. Intravitreal injection of interleukin (IL) 1, IL-6 and prostaglandin (PG) E₂ induced a significant increase in flare values. Following these treatments, introduction of a PG synthetase inhibitor can partially ameliorate BAB disruption. IL-1, IL-6 and PGE₂ may be involved in BAB disruption following retinal photocoagulation and cryopexy.

Prognostic value of alkaline phosphatase flare in patients with metastatic prostate cancer treated with endocrine therapy

Objectives. To assess the prognostic significance of alkaline phosphatase (ALP) flare in 114 patients with metastatic prostate cancer treated with endocrine therapy. Methods. ALP flare was defined as a transient increase of the serum ALP level to 120% or more of the pretreatment value after the initiation of endocrine therapy, followed by a subsequent decrease. Results. Univariate analysis demonstrated that patients with poorly differentiated adenocarcinoma, an extent of disease of 2 or greater, a serum ALP level above twice the upper limit of normal, a serum prostate-specific antigen level greater than 100 ng/mL, an ALP flare, and a hemoglobin level of 12 g/dL or less had a significantly lower survival rate than their respective counterparts. Multivariate Cox’s proportional hazards model analysis demonstrated that tumor histologic features and ALP flare were significant prognostic indicators for survival. Conclusions. The results of the present study suggest that the tumor histologic features and the ALP flare are significant prognostic indicators for survival in patients with metastatic prostate cancer treated with endocrine therapy.

Intraocular lidocaine in phacoemulsification: An endothelium and blood–aqueous barrier permeability study

Objective To evaluate the effects of intraocular lidocaine hydrochloride (HCl) on the corneal endothelium and of blood–aqueous barrier (BAB) permeability in ultrasound phacoemulsification. Design Nonrandomized, comparative trial. Participants Sixty patients who underwent uneventful, single-surgeon, clear cornea phacoemulsification were studied prospectively. Methods Sub-Tenon’s anesthesia was administered to 30 patients (group 1), and intraocular lidocaine hydrochloride was administered to an additional 30 patients (group 2). An endothelial study of at least 120 cells per patient, using a noncontact specular microscope and a digital image analysis system, was performed before surgery and 1 month after surgery. Blood–aqueous barrier permeability was evaluated preoperatively and postoperatively (48 hours, 1 week and 1 month) using a laser flare meter. Main outcome measures Endothelial parameters (cell density, hexagonality, and coefficient of variation in cell area) and BAB permeability. Results No significant differences were found between groups when comparing the postoperative changes produced in endothelial cell density (95% confidence interval [CI], 0.46, 4.7; P = 0.10), hexagonality (95% CI, −2.5, 3.5; P = 0.72), and coefficient of variation in cell area (95% CI, −8.3, 4.6; P = 0.57). A multivariate study detected no significant differences in mean flare values between groups during follow-up ( P = 0.40). No clinically significant differences were found between mean preoperative and 1 month postoperative flare values in either group. Conclusions The recovery of BAB permeability 1 month after surgery seems to suggest that no additional inflammation was induced by intraocular lidocaine HCl. The fact that no differences in postoperative changes in endothelial parameters were found between groups indicates that no further corneal endothelial damage (other than that caused by surgical manipulation) was incurred. According to our results, intracameral lidocaine HCl appears to be safe for the average phacoemulsification patient in the absence of ocular pathologic conditions.

Long-term disorders of the blood-aqueous barrier after small-incision cataract surgery.

To determine the long-term function of the blood-aqueous barrier after small-incision cataract surgery with implantation of a foldable intraocular lens. The blood-aqueous barrier function in 74 eyes of 62 patients who underwent cataract surgery was examined using a laser flare-cell meter. The measurements were performed pre-operatively and post-operatively between 12 and 35 months after surgery. For statistical analysis a linear regression was used. The study was designed as a single cohort study, with comparison of pre- and post-operative values. Highly statistically significant differences (p < 0.0001) were found between pre-operative flare values and those measured at the final visit. The linear regression model showed significantly higher flare values post-operatively compared with those measured pre-operatively. Other variables such as incision technique, sex, operation time, phaco time and systemic disease had no influence on this outcome. The results suggest that there is persistent blood-aqueous barrier dysregulation even several years after cataract surgery.

Cystoid macular edema after phacoemulsification: relationship to blood–aqueous barrier damage and visual acuity

PurposeTo ascertain the incidence of cystoid macular edema (CME) after phacoemulsification and its relationship to blood–aqueous barrier damage and visual acuity. SettingA British teaching hospital. MethodsA prospective trial was performed to document the incidence of CME after routine phacoemulsification with continuous curvilinear capsulorhexis. LogMAR visual acuity and laser flare were measured using the KOWA FC 1000 laser cell–flare meter preoperatively and 1, 14, 30, and 60 days postoperatively. At day 60, a standardized fluorescein angiogram was performed and graded by masked observers. ResultsThe rate of angiographic CME on day 60 was 19%. Visual acuity at each visit was significantly worse in the CME group (P < .05). The flare and cell values at days 14, 30, and 60 were higher in the CME group at day 60; however, the difference was not statistically significance (P > .05). ConclusionsThe incidence of CME after routine phacoemulsification was 19%. Patients with CME at day 60 had significantly worse visual acuity than those who did not from the first postoperative day throughout the follow-up. There was a trend for patients who had CME at day 60 to have more postoperative inflammation.

Course of postoperative inflammation after implantation of 4 types of foldable intraocular lenses

Purpose To compare the course of postoperative inflammation after small incision cataract surgery with implantation of 4 types of foldable intraocular lenses (IOLs). Setting Department of Ophthalmology, University Hospital of Vienna, Austria. Methods One hundred twenty eyes were prospectively randomized to receive a foldable silicone (Pharmacia 920), hydrogel (Bausch & Lomb Hydroview™), methyl methacrylate/hydroxyethyl methacrylate (Mentor MemoryLens®), or acrylic (Alcon AcrySof®) IOL. All surgery was performed by the same experienced surgeon using a standardized surgical protocol: clear corneal incision, capsulorhexis, phacoemulsification, and in-the-bag implantation of the IOL. All patients received standardized postoperative medication and follow-up. Postoperative inflammation was evaluated by measuring aqueous flare preoperatively and 1, 3, 7, 14, 28, 90, and 180 days after surgery using the Kowa 1000 laser flare–cell meter. Results Except on the first day after surgery, when the AcrySof group had higher flare values than the other groups ( P = .0265), no significant differences were found up to 6 months. Re-establishment of the blood−aqueous barrier was similar in eyes with the AcrySof, Hydroview, and MemoryLens IOLs; the course of postoperative inflammation was different in eyes with the silicone IOL. Conclusion Comparison of postoperative flare values after implantation of 4 foldable IOLs showed no clinically relevant differences in the course of postoperative inflammation.

Quantification of aqueous flare after phacoemulsification with intraocular lens implantation in eyes with pseudoexfoliation syndrome.

Impairment of the blood-aqueous barrier is a frequent finding in eyes with pseudoexfoliation syndrome (PEX). To perform noninvasive quantification of aqueous flare using the laser flare-cell meter to analyze blood-aqueous barrier breakdown following phacoemulsification with intraocular lens implantation in eyes with and without PEX. After other conditions that might account for impairment of the blood-aqueous barrier were excluded, 11 eyes with PEX and 11 eyes with senile cataract without PEX were included in the study. Aqueous flare was quantitatively determined using a laser flare-cell meter preoperatively as well as 1, 3, and 5 days postoperatively. Phacoemulsification with posterior chamber intraocular lens implantation was performed by one surgeon. On the first postoperative day, flare values (calculated as mean+/-SD photon counts per millisecond) in eyes with PEX were higher (42.2+/-21.3) than in eyes without PEX (30.6+/-15.1) (P>.05). On days 3 and 5, postoperative flare values decreased slowly in eyes with PEX (23.9+/-7.4 and 21.2+/-5.7 photon counts per millisecond, respectively) and were significantly higher than in eyes without PEX (14.8+/-5.4 and 10.5+/-1.4 photon counts per millisecond, respectively) (P<.05). Breakdown of the blood-aqueous barrier is significantly more extensive in eyes with PEX and may be an important risk factor for early postoperative complications. The altered response to surgery should be considered in eyes with PEX.

Quantification of Blood-Aqueous Barrier Breakdown after Trabeculectomy

Impairment of the blood-aqueous barrier in unoperated eyes with pseudoexfoliation syndrome has been demonstrated by fluorescein angiography, fluorophotometry, measurement of aqueous flare, and determination of aqueous protein. We performed noninvasive quantification of aqueous flare using the laser flare-cell meter to compare blood-aqueous barrier breakdown after trabeculectomy in eyes with primary open-angle glaucoma (POAG) and in eyes with pseudoexfoliative glaucoma (PEX). Twenty eyes with PEX and 20 eyes with POAG were included in the study. Trabeculectomy was performed by two surgeons according to a standard trabeculectomy technique. Intra- and postoperative treatments were identical in both groups. Aqueous flare was quantitatively determined using the laser flare-cell meter FC-1000 (Kowa, Tokyo, Japan) before and 3, 5, 7, and 9 days after trabeculectomy. Absolute flare and difference between post- and preoperative flare values were statistically analyzed using the Mann-Whitney U-Test for independent samples. Before surgery, aqueous flare values were significantly higher in PEX than in POAG. On days 3, 5, 7 and 9 after surgery, flare values were significantly higher in eyes with PEX than in eyes with POAG. Absolute differences between post- and preoperative flare values also were significantly higher in eyes with PEX, but this was not true for percentage values. These results show that substantial blood-aqueous barrier breakdown occurs in eyes with PEX after trabeculectomy. These alterations may contribute to early or late complications of trabeculectomy and indicate the need for close postoperative follow-up evaluation in eyes with PEX.

Inflammation after phacoemulsification in patients with type 2 diabetes mellitus without retinopathy: Prospective study

Purpose: To evaluate inflammation after clear corneal incision (CCI) cataract surgeryin patients with noninsulin-dependent diabetes mellitus and no retinopathy. Methods: Forty patients with diabetes and 40 age-matched controls had standardized temporal CCI cataract surgery with implantation of a foldable intraccular lens. Anterior chamber flare was evaluated in an undilated eye with a laser flare-cell meter preoperatively and 1, 3, 7, 14; and 28 days postoperatively. Results: In both groups, flare and cell values increased on the first postoperative dayand successively decreased on the following days. Flare had not recovered to preoperative values by day 28. At no time was there a significant mean difference in cell and flare between the 2 groups. Conclusion: It does not appear necessary to alter the postoperative therapeuticregimen in patients with type 2 diabetes mellitus and no retinopathy.

Quantification of blood-aqueous barrier breakdown after photorefractive keratectomy for myopia.

Photorefractive keratectomy (PRK) using the excimer laser is a well-established surgical technique for correction of mild to moderate myopic refraction errors in case of spectacle or contact lens incompatibility. As it is still uncertain whether this procedure causes intraocular inflammatory changes, it was the purpose of this study to quantify breakdown of the blood-aqueous barrier following PRK and to look for possible correlations with clinical parameters. Aqueous flare was quantified using the laser flare-cell meter after medical pupil dilation preoperatively and on days 1, 3 and 7 as well as 1 month and 3 months following PRK with a 193-nm excimer laser (MEL 60, Aesculap-Meditec) in 37 eyes of 22 patients. The preoperative spherical equivalents were -4.4 +/- 3.1 D (range -1.5 to -8.0 D). Pre-, intra- and postoperative treatment was standardized. Preoperatively, aqueous flare values were 3.9 +/- 0.8 photon counts/ms and showed no significant correlation with the spherical equivalent (p > 0.1). Postoperatively, aqueous flare rise was very small with flare values not significantly higher than preoperative values. All postoperative flare values were below the normal limit (< 8.0 photon counts/ms). Flare was highest on day 3 after PRK surgery. There was no statistically significant correlation between aqueous flare and depth of stromal ablation. The number of aqueous "cells" did not increase following PRK at any postoperative follow-up examination. Our results indicate that PRK in mild to moderate myopia does not cause a significant breakdown of the blood-aqueous barrier.

Blood-Aqueous Barrier Disruptionin Expe rimental Anterior Segment Ischemia in Rabbit Eyes

The blood-aqueous barrier (BAB) in experimentally induced anterior segment ischemia (ASI) following strabismus or retinal detachment surgery in pigmented rabbits was evaluated by laser flare photometry. Four simultaneous rectus tenotomies produced a significantly higher flare value on the 1st postoperative day. Obstruction of one or two vortex veins produced significantly high flare values on the 1st and 3rd postoperative days. Scleral buckling with interference of one vortex vein produced a higher flare value than that with buckling alone. Interference of three vortex veins by diathermy and the encircling procedure produced serious ASI. Disruption of BAB in ASI can be detected quantitatively with laser flare photometry. Introduction of prostaglandin synthetase inhibitor resulted in a significant reduction of flare values following surgery. Prostaglandin synthetase inhibitor can partly ameliorate BAB disruption.

Laser-Tyndallometrie bei Augen mit akutem retinalen Nekrosesyndrom

Acute retinal necrosis syndrome (ARN) is a rapidly progressive viral necrotic retinitis. We used noninvasive measurement of aqueous flare to quantify blood-ocular barrier breakdown in eyes with ARN und to follow the inflammatory activity and treatment effects. We report on seven patients (5 males und 2 females, age: 16 to 57 years) with ARN that were treated in our institution between 1991 to 1996. Aqueous flare was quantified regularly during treatment using the laser flare-cell meter (Kowa, FC-1000) following pupillary dilation. Aqueous flare was highly significantly increased in eyes with ARN (145.5 +/- 139.7, range 30 to 367 photon counts/ms). Contralateral, unaffected eyes showed normal flare values (3.6 +/- 0.8 photon counts/ms, p < 0.0001; normals: 4.1 +/- 1.1 photon counts/ms). Flare values correlated with inflammatory activity before and during antiviral treatment. In two patients with ARN caused by herpes simplex-virus aqueous flare values were extremely increased (367 and 316 photon counts/ms), and retinal necrosis was rapidly progressive despite antiviral therapy. One patient developed early ARN in his contralateral eye with flare values increasing from 3.5 to 22.0 photon counts/ms, which quickly normalized following antiviral treatment. Measurement with the laser flare-cell meter allows quantification of blood-ocular barrier breakdown in eyes with ARN und may be useful for monitoring inflammatory activity during treatment.

Posterior continuous curvilinear capsulorhexis and postoperative inflammation

Purpose: To evaluate the influence of posterior continuous curvilinear capsulorhexis (PCCC) on inflammation after phacoemulsification and implantation of a foldable silicone intraocular lens (IOL) in the capsular bag.Setting: St. Erik's Eye Hospital, Stockholm, Sweden.Methods: Fifty patients were enrolled in this prospective, randomized study. Eyes with diabetes mellitus, glaucoma, uveitis, exfoliation syndrome, other previous ocular diseases, or an axial length greater than 26.0 mm were excluded. One group comprised 25 eyes of 25 patients (median age 76 years) in which phacoemulsification and implantation of a silicone IOL in the capsular bag were performed. The other group consisted of 25 eyes of 25 patients (median age 77 years) who received the same surgical procedure in addition to PCCC. The aqueous protein concentration was measured using a laser flare meter (FC 500, Kowa Co.) preoperatively and 1 day, 1 week, and 1 and 3 months after surgery.Results: Surgical trauma significantly increased aqueous flare values 1 day, 1 week, and 1 month after surgery in both groups (P < .05). Three months postoperatively, flare values in both groups were not different from preoperative values. No difference between the 2 groups was found in flare intensity measurements or in best corrected visual acuity before and after uneventful surgery. The incidence of postoperative clinical cystoid macular edema was 8% (2 eyes) in the control group and 4% (1 eye) in the group with PCCC.Conclusion: Postoperative flare intensity after phacoemulsification with PCCC and implantation of a foldable silicone IOL was not significantly different than postoperative flare measurements in a control group.

Effect of mitomycin C on aqueous humor flow, flare and intraocular pressure in eyes with glaucoma 2 years after trabeculectomy.

The purpose of this study was to determine the intraocular pressure (IOP), aqueous humor flow, flare and ocular side effects in eyes with a history of hypotony after trabeculectomy with adjunctive mitomycin C (MMC). Thirty-six eyes with primary or secondary open-angle glaucoma and IOP < or = 8 mmHg during the postoperative period were studied 745 +/- 315 days after surgery. MMC (0.2 or 0.5 mg/ml) was applied to the episclera with a cellular sponge. Flare was studied with the Kowa Laser Flare Meter 500. Aqueous humor flow was measured in the afternoon (Fluorotron Master II). IOP, visual fields and best corrected visual acuity were also examined. Twenty-two contralateral eyes without surgical intervention served as controls. The mean age of patients was 44.5 +/- 16.8 years. The mean IOP was significantly lower in the MMC group than in the control group: 9.6 +/- 6.4 mmHg vs 18.0 +/- 13.6 mmHg at 2 years (P < 0.001). Aqueous flow was significantly lower in subjects treated with MMC than in controls (P < 0.001). The flare values were significantly higher in the MMC-treated group, with a mean of 12.0 +/- 7.7 photon counts/ms, than in the control group, mean 7.9 +/- 4.6 photon counts/ms (P < 0.019). Our data suggest that MMC is a useful ocular hypotensive agent which seems to participate in a change in aqueous humor dynamics when applied topically as an aqueous solution.

Subclinical inflammation after laser in situ keratomileusis

Purpose: To determine whether laser in situ keratomileusis (LASIK) for the correction of myopia induces an anterior chamber inflammatory response measurable with laser flare-cell photometry.Setting: Instituto Oftalmolãgico de Alicante, University of Alicante, Alicante, Spain.Methods: Twenty eyes in 20 patients had LASIK to correct myopia ranging from 2.50 to 15.00 diopters (D) (mean -8.94 ± 3.25 [SD]). Anterior chamber inflammation was measured preoperatively and 1, 3, 7, and 15 days and 1 and 3 months postoperatively using the flare mode of a laser flare-cell meter. All eyes received topical fluorometholone 0.1% drops for 2 weeks postoperatively.Results: Anterior chamber flare values at 1 and 3 days and 1 week postoperatively were not significantly different from those found preoperatively. However, a significant decrease was found at 2 weeks and 1 month (P < .01 and P < .05, respectively). Flare values returned to their preoperative levels at 3 months. No significant correlations between postoperative flare values and depth of ablation were found.Conclusion: In this study, LASIK did not induce an inflammatory response in the anterior chamber in the myopic eye.

Aqueous flare intensity after phacoemulsification in patients with diabetes mellitus

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.