青光眼滤过术后超声乳化白内障摘出人工晶状体植入术疗效观察

目的 探讨青光眼滤过术后颞侧透明角膜切口超声乳化白内障摘出及人工晶状体植入术后的疗效及并发症。方法 对32例(39眼)有青光眼滤过手术史的患者进行颞侧透明角膜切口超声乳化白内障摘出及人工晶状体植入术,观察其术中术后并发症、最佳矫正视力及眼压的变化。 结果 术后1个月视力较术前提高者37眼(94.87％),其中术后矫正视力大于等于0.5者25眼(64.10％)。术前眼压(单位:mmHg):14.69±5.14,术后1 d、1周、3个月分别为16.92±5.99、1 5.01±3.88、14.06±3.54。术后1d眼压较术前显著性增高,P<0.01。术中1例发生后囊破裂,术后2例发生后发障。结论青光眼滤过术后颞侧透明角膜切口超声乳化白内障摘出及人工晶状体植入术能使患者获得较好的视功能恢复,且并发症少。     

青光眼术后白内障超声乳化吸出术的临床观察

目的　探讨抗青光眼滤过手术后白内障超声乳化吸出及人工晶状体植入术的手术技巧及效果。方法　对行小梁切除术后白内障患者 82眼 ,采用经颞侧透明角膜切口行超声乳化吸出及折叠式人工晶状体植入术 ,术后随访 1～ 6月 ,平均 3月。结果　术后随访所有患者视力均较术前有所提高 ,其中视力≥ 0 5者 68眼占 82 93 % ,术后平均眼压为 (14 2 2± 2 5 1)mmHg(1mmHg =0 13 3kPa)。滤过泡无瘢痕化改变。结论　把握手术时机和适应证 ,具备娴熟的晶状体超声乳化手术技巧 ,经颞侧透明角膜切口行超声乳化吸出联合人工晶状体植入术 ,在抗青光眼滤过手术后白内障的治疗上能取得良好的效果。     

小梁切除联合白内障超声乳化人工晶状体植入术的临床效果

目的　探讨小梁切除术联合白内障超声乳化吸除后房型人工晶状体植入术 (三联术 )的临床效果。方法　对 4 0例 (4 6只眼 )不同类型的青光眼伴白内障患者行小梁切除术联合白内障超声乳化吸除并植入后房型人工晶状体。结果　术后视力 0 .5以上者 4 2只眼 ,占 91.3% ,术后平均眼压 (2 .13± 0 .6 4 ) k Pa,较术前降低 3.5 4 k Pa,差异具有显著性 (P <0 .0 1)。功能性滤过泡为 93.4 8%。结论　小梁切除术联合白内障超声乳化吸除并后房型人工晶状体植入术具有眼压控制好、术后视力恢复满意、并发症少的优点 ,是值得推广的手术     

超声乳化白内障吸除术对血-房水屏障功能的影响

目的　观察小切口超声乳化白内障吸除人工晶状体植入术及相关因素对血 房水屏障功能的影响。方法　使用激光蛋白细胞检测仪对 60例 (64只眼 )白内障患者超声乳化白内障吸除人工晶状体植入术前、后的房水蛋白浓度进行定量检测 ,记录并比较闪光值。术后随访时间为 3个月。结果　超声乳化白内障吸除人工晶状体植入术前 ,术后 1d、1周、1个月及 3个月术眼房水的平均闪光值分别为 (6 94± 0 3 4 )、(2 6 2 7± 1 3 7)、(13 96± 1 0 5)、(9 0 7± 0 43 )及 (7 16± 0 2 7)光粒子数 /ms ,其中术后 1d、1周及 1个月高于术前 ,且差异均有显著意义 (P <0 0 5) ;术后 3个月与术前比较 ,差异无显著意义 (P >0 0 5)。术后早期术眼房水蛋白浓度与患者年龄呈正相关 (r =0 40 0 ,P =0 0 0 1) ,与患者的性别和眼别均无相关。术中虹膜脱出者术后 1d和 1周血 房水屏障功能破坏严重。结论　超声乳化白内障吸除人工晶状体植入术在术后短期内影响术眼的血 房水屏障功能 ;激光蛋白细胞检测仪可动态评价超声乳化白内障吸除术对血 房水屏障功能的影响。 (中华眼科杂志 ,2 0 0 4,40 :2 6 2 9)     

超声乳化白内障吸除人工晶状体植入治疗恶性青光眼

目的:观察超声乳化白内障吸除后房型人工晶状体植入治疗恶性青光眼的临床疗效。方法:对18例(18眼)青光眼滤过手术后发生的恶性青光眼,超声乳化白内障吸除、后房型人工晶状体植入、小梁切除。结果:术后前房不同程度加深,眼压控制正常,术前眼压:5.47±1.53kPa,术后眼压:2.31±0.32kPa。视力不同程度提高,<0.05者1眼(5.5%),0.1～0.3者11眼(61.1%),>0.4者7眼(38.9%)。并发症:瞳孔区渗出膜5眼(27.8%),虹膜后粘连6眼(33.3%)、前粘连2眼(11.1%),角膜内皮水肿6眼(33.3%)。结论:超声乳化白内障吸除后房型人工晶状体植入是治疗恶性青光眼的有效方法之一。     

青光眼滤过术后超声乳化人工晶状体植入观察

目的探讨青光眼滤过术后表面麻醉下颞侧透明角膜切口超声乳化白内障摘出及人工晶状体植入术后的疗效及并发症。方法对29例(30眼)有青光眼滤过史的患者，表面麻醉下进行颞侧透明角膜切口超声乳化白内障摘出及人工晶状体植入术，观察其术中术后并发症，以及矫正视力。结果30眼均顺利完成超声乳化摘出及人工晶状体植入。术后1周，视力0．06者1眼，0．1～0．2者3眼，0．3～0．5者10眼，大于0．5者16眼。术中2例(2眼)发生后囊破裂，术后房水闪光( )，人工晶状体表面色素沉着，角膜水肿等并发症。结论青光眼滤过术后，表面麻醉下颞侧透明角膜切口超声乳化白内障摘出及人工晶状体植入术能使患者获得较好的视力，并发症少。     

青光眼滤过术后白内障超声乳化吸除联合折叠式人工晶状体植入

目的评价青光眼滤过术后白内障超声乳化吸除联合折叠式人工晶状体植入的疗效.方法对18只青光眼滤过术后白内障眼采用3.5mm的隧道切口行白内障超声乳化吸除联合折叠式人工晶状体植入,术后切口不缝合.随访3～30个月,观察术后视力,角膜散光及眼压等情况.结果18只眼术后视力均较术前提高,其中0.02者1只眼(0.06%),0.05～0.2者2只眼(11.1%),0.3～0.4者5只眼(27.8%),0.5～0.9者7只眼(38.9%),1.0～1.2者3只眼(16.7%).术前角膜散光(0.78±0.88)D,术后1周,1个月,3个月角膜散光分别为(0.89±0.80)D,(0.75±0.82)D,(0.72±0.78)D,与术前相比P＞0.05(t检验),差异无显著性,术前眼压为(2.13±0.34)kPa,术后1个月眼压为(2.20±0.23)kPa,与术前相比P＞0.05(t检验),差异无显著性.结论对于青光眼滤过术后白内障采用超声乳化吸除联合折叠式人工晶状体植入可较易避开滤过泡,术后反应轻.角膜散光无明显改变,患者术后视功能改善且不影响眼压的控制,手术安全可靠.     

青光眼术后白内障小切口非超声乳化摘出术

目的　探讨抗青光眼滤过手术后白内障的手术方法。方法　对抗青光眼滤过手术后白内障 36例 (38眼 )采用颞上象限小切口非超声乳化白内障摘出人工晶状体植入术 ,随访 3月。结果　白内障手术后患者视力均有明显提高 ,视力≥ 0 5者占 65 8%。均有功能性滤过泡 ,未见瘢痕化。术后平均眼压 (1 4 6± 2 62 )mmHg。结论　抗青光眼滤过手术后白内障患者进行颞上象限小切口非超声乳化白内障摘出人工晶状体植入可明显提高视力 ,保持滤过泡功能 ,维持正常眼压     

肝素修饰人工晶体植入在抗青光眼术后白内障超声乳化术中的应用

目的观察肝素表面修饰折叠型人工晶体植入对抗青光眼术后白内障超声乳化吸除术后前房炎症反应的影响。方法对60例(88眼)抗青光眼术后白内障患者施行超声乳化吸除术,所有病例随机植入肝素表面修饰折叠型人工晶体或蓝光滤过折叠型人工晶体。应用激光闪光细胞检测仪(Laserflarecellmeter,LFCM)测量并比较术前及术后1天、7天、30天及90天房水的平均闪辉值,以评价前房炎症反应。并观察术前后的视力、眼压及滤过泡和角膜内皮计数情况。结果(1)术前,二组患者房水闪辉值没有显著性差异,植入肝素表面修饰折叠型人工晶体者,手术后7天内的房水闪辉值均明显低于蓝光滤过折叠型人工晶体植入组,而术后30、90天时两种人工晶体植入者之间差异无显著性。两组术后视力均明显提高,眼压控制稳定,角膜内皮功能正常。结论抗青光眼术后白内障手术后眼血-房水屏障功能受损,植入肝素表面修饰折叠型人工晶体能显著减轻白内障术后短期内的炎症反应,增加了手术安全性。     

糖尿病患者小切口超声乳化白内障吸除人工晶体植入术对血-房水屏障功能的影响

目的探讨小切口超声乳化白内障吸除联合人工晶体植入术对糖尿病患者血-房水屏障功能的影响以及相关因素。方法选取小切口超声乳化白内障吸除联合人工晶体植入术的连续病例为本研究对象。使用激光闪辉细胞计量仪在术前和术后1月内检测DM组和对照组病例平均前房闪辉计数值。结果DM组32眼和对照组15眼在术前1天,术后1、3、7和30天时的平均前房闪辉计数值分别为3.63±3.00和3.27±1.78、29.54±12.75和19.68±8.54、18.12±10.94和12.47±3.95、10.68±6.46和8.37±3.49,以及7.28±3.84和6.36±2.07(光粒子数/毫秒)。影响手术后1天和3天时DM组平均前房平均闪辉计数值改变的独立因素都仅为累计超声乳化时间。结论小切口超声乳化白内障吸除联合人工晶体植入术导致DM眼原先已存在的血-房水屏障破坏迅速加重。尽量减少超声乳化时间有助于DM患者手术引起的血-房水屏障破坏。     

Blood-aqueous barrier after phacoemulsification with posterior chamber lens implantation; foldable acrylate lens vs PMMA lens-- a clinical study on 46 eyes

BACKGROUND: Cataract surgery leads to a more or less pronounced postoperative inflammation due to breakdown of the blood-aqueous barrier. This alteration of the blood-aqueous barrier can be reduced by minimally invasive surgery. The purpose of this study was to quantify the early course of the postoperative alteration of the blood-aqueous barrier following phacoemulsification with implantation of conventional PMMA posterior chamber lens (IOL) in comparison with foldable acrylic lens implantation. PATIENTS AND METHODS: Forty-six eyes of 46 patients (age 63 +/- 8.8 years) without preexisting deficiences of the blood-aqueous-barrier or previous intraocular surgeries were divided into two groups: group 1 (24 patients): phacoemulsification with one-piece-PMMA-IOL implantation (6.5 mm corneoscleral tunnel incision); group 2 (22 patients): phacoemulsification with foldable acrylic-IOL implantation (3.5 mm incision, 15 patients with corneoscleral tunnel and 7 patients with clear cornea incision). All surgical procedures were performed by one surgeon. The postoperative treatment was standardized. Alteration of the blood-aqueous barrier was quantified by the laser flare-cell meter (Kowa, FC-1000) preoperatively and on the first and the second day after surgery. RESULTS: Preoperative aqueous flare values (photon counts/ms) were comparable in both groups (6.7 +/- 2.7 versus 5.6 +/- 2.7 respectively, p = 0.1). On day 1, aqueous flare in group 1 (9.7 +/- 2.9) was not statistically significantly higher than in group 2 (9.2 +/- 2.2, p = 0.2) and remained relatively constant on day 2 after surgery (9.3 +/- 3.3), whereas the aqueous flare values in group 2 decreased statistically significant (6.7 +/- 2.3, p = 0.01). Postoperatively, there was no statistically significant difference of aqueous flare values between eyes with corneoscleral tunnel incision and eyes with clear corneal incision (p = 0.7) in group 2. CONCLUSIONS: Our study shows that phacoemulsification with foldable IOL implantation leads to a mild and short-lasting alteration of the blood-aqueous barrier. Thus, implantation of foldable IOL may be useful in eyes especially with preexisting alteration of the blood-aqueous-barrier.     

Anterior chamber inflammation following cataract surgery in patients with non-insulin-dependent diabetes mellitus

PURPOSE: The aim of the study was to estimate the early breakdown of the blood-aqueous barrier (BAB) following uneventful cataract surgery in patients with non-insulin dependent diabetes mellitus. MATERIAL AND METHODS: Aqueous flare was estimated in 54 diabetic eyes before and after cataract surgery. Fifteen eyes underwent uneventful ECCE (extracapsular cataract extraction with "can opener" capsulotomy) and 39 phacoemulsification with continuous curvilinear capsulorhexis. All procedures were performed by experienced surgeons. Fifty six eyes of age-matched healthy patients undergoing uncomplicated cataract surgery served, as control. Anterior chamber flare was quantified preoperatively, 1 and 3 days postoperatively, using laser-flare meter (Kowa FM-500). Laser flare values were expressed in photon counts/millisecond. RESULTS: Mean preoperative anterior chamber flare in diabetes type 2 was as follows: normal fundus--6.7, background retinopathy--8.6 and proliferative retinopathy--14.1 (p < 0.01 vs NF group). Significantly lower anterior chamber flare measurements following phacoemulsification (25.0-1 day, 17.8-3 days post surgery), than after ECCE (63.7 and 45.6, respectively) (p < 0.01) were observed in diabetic eyes. In phaco group, we noted lower flare values in eyes without retinopathy; 25.2-1 day, 14.0-3 days post surgery, than in proliferative retinopathy (31.5 and 28.4, respectively) (p < 0.05 vs no retinopathy group). CONCLUSIONS: Phacoemulsification, as a less traumatising technique produces less BAB breakdown and seems to be more suitable than ECCE in diabetic eyes. Following phacoemulsification, eyes with proliferative retinopathy had significantly higher flare values than eyes without retinopathy.     

Quantification of blood-aqueous barrier breakdown after phacoemulsification in Fuchs' heterochromic uveitis

PURPOSE: To quantify the breakdown of the blood-aqueous barrier (BAB) following phacoemulsification with posterior chamber lens implantation in eyes with Fuchs' heterochromic uveitis (FHU). PATIENTS AND METHODS: In this retrospective study, 19 eyes of 19 patients with FHU (mean age 38 +/- 14 years) and 35 eyes of 35 patients with senile cataracts (mean age 63 +/- 9 years) underwent phacoemulsification with one-piece PMMA posterior chamber lens implantation. Aqueous flare was quantified using the laser flare-cell meter (LFCM, Kowa FC-1000) following medical pupillary dilation preoperatively and 1, 3, and 5 days, then 1 and 6 weeks and 6 months postoperatively. RESULTS: Mean preoperative aqueous flare (in photon counts per millisecond) in FHU vs. controls was 11.7 +/- 3.5 vs. 5.8 +/- 1.7. Following cataract surgery, mean aqueous flare increased to 27.8 +/- 4.4 vs. 16.0 +/- 4.5 on day 1, decreased to 23.6 +/- 4.0 vs. 11.8 +/- 3.5 on day 3, and to 18.0 +/- 3.0 vs. 9.5 +/- 1.7 on day 5. In FHU eyes, it was 13.9 +/- 2.7 after 1 week, and had returned to preoperative levels after 6 weeks (10.9 +/- 2.5) and remained stable for up to 6 months (mean 10.3 +/- 2.2). Pre- and postoperatively, aqueous flare values were 2-3 times higher in FHU eyes than in control eyes with senile cataract (p = 0.01). No postoperative complications such as fibrin formation, synechiae, macrophages on the intraocular lens optic or endophthalmitis were observed in any of the patients. CONCLUSIONS: BAB breakdown following phacoemulsification with posterior chamber lens implantation is relatively mild in eyes with FHU and the BAB appears to be fully reestablished to preoperative levels 6 weeks postoperatively, explaining the usually good outcome of cataract surgery in this condition.     

Increased aqueous flare intensity in eyes with liquefied after-cataract

PURPOSE: To describe aqueous flare intensity in eyes with white liquefied after-cataract. SETTING: Department of Ophthalmology, Toyama Medical and Pharmaceutical University, Toyama, Japan. METHODS: Seven patients with unilateral liquefied after-cataract and another 10 unaffected patients with an intraocular lens (IOL) were examined. The eyes were divided into 3 groups. The first group was composed of 7 eyes with liquefied after-cataract. The second group included the fellow eyes of the patients with unilateral liquefied after-cataract; 4 had an IOL, and 3 had cataract. The third group included 10 additional eyes without liquefied after-cataract. All patients underwent cataract operations consisting of phacoemulsification/aspiration with continuous curvilinear capsulorhexis and acrylic IOL implantation in the capsular bag. Aqueous flare was measured using a laser flare-cell meter. RESULTS: The mean +/- SD of aqueous flare intensity was significantly higher in the first group (11.8 +/- 1.8 photon counts/msec) than in the second group (6.4 +/- 0.8 photon counts/msec) and in the third group (6.3 +/- 0.7 photon counts/msec). CONCLUSION: It is possible that liquefaction of after-cataract and disruption of the blood-aqueous barrier may be related.     

Disorders of the blood-aqueous barrier after phacoemulsification in diabetic patients

PURPOSE: To evaluate the function of the blood-aqueous barrier after phacoemulsification with implantation of a foldable intraocular lens (IOL) in diabetic patients. METHODS: All patients were enrolled from those scheduled for phacoemulsification with intraocular lens implantation in Zhongshan Ophthalmic Center Guangzhou from March 2002 to June 2002. The classification on diabetic retinopathy (DR) was based on the fundus examination after cataract surgery. The blood-aqueous barrier function was examined using the laser flare cell meter (Kowa FC-2000) preoperatively and on postoperative days 1, 7, 30, and 90 by an independent examiner who was masked to the DR classification. Patients were operated by one experienced surgeon as per standard clinical protocol and were provided the same postoperative medical care. A linear regression and Wilcoxon test were used for the analysis. RESULTS: A total of 112 patients were divided into three groups: patients without diabetic mellitus as normal control (n=56), diabetic patients without diabetic retinopathy (n=2), with nonproliferation diabetic retinopathy (NPDR) (n=37), and diabetic patients with proliferation diabetic retinopathy (PDR) (n=17). All patients were examined and successfully followed up for 3 months after cataract surgery. Aqueous flare mean photon counts in PDR, NPDR, and control eyes were 8.94+/-0.57, 7.03+/-0.27, and 6.94+/-0.34 before surgery and increased to 32.42+/-0.67, 26.07+/-0.83, 26.27+/-1.37 on the first day after surgery (P<0.05), then decreased to 19.86+/-0.78, 14.08+/-0.54 and 13.96+/-1.05 at 7 days after surgery (P<0.05), 13.24+/-0.29, 9.86+/-0.33, and 9.07+/-0.43 at 30 days after surgery (P<0.05); eventually, the counting decreased to 11.25+/-0.31, 7.24+/-0.67, and 7.16+/-0.27 at 90 days after surgery (P<0.05). Linear regression model suggested that other potential variables, such as age, sex, eye (left/right), phaco time, phaco energy, and hypertension were not related to the outcome. For patients without diabetes mellitus and diabetic patients with NPDR, highly statistically significant differences (P<0.05) were found between preoperative flare value and those measured on days 1, 7, and 30 after surgery, but no statistically significant differences (P>0.05) were found between the preoperative flare value and those measured on postoperative days 90. However, patients with PDR still had a higher flare value even on postoperative day 90. The patients with intraoperative iris prolapse had a higher flare value between days 1 and 7 postoperatively. CONCLUSION: Phacoemulsification with a foldable intraocular lens implantation affects the blood-aqueous barrier more severely in diabetic patients with PDR than patients with NPDR and nondiabetic patients.     

Analysis of the blood aqueous barrier by measurement of aqueous flare in 31 eyes with Fuchs' heterochromic uveitis with and without secondary open-angle glaucoma

BACKGROUND: Fuchs' heterochromic uveitis is characterized by low-grade intraocular inflammation and a relatively benign clinical course. It was the aim of this study to quantitatively determine alterations of the blood-aqueous barrier in this disease by measuring the aqueous flare. METHODS: 31 affected eyes of 31 patients with the characteristic clinical picture of Fuchs' heterochromic uveitis, 31 apparently unaffected contralateral eyes, and 120 age and sex-matched normal control eyes were included in this retrospective study. Five of the eyes with Fuchs' heterochromic uveitis showed signs of secondary open-angle glaucoma. Determination of aqueous flare was performed in all eyes using the laser flare-cell meter FC-1000 (Kowa, Japan) after pupillary dilation. RESULTS: Aqueous flare values were moderately but significantly increased in eyes with Fuchs' heterochromic uveitis (mean 12.1 +/- 3.6 photon counts/ms) in comparison to normal control eyes (4.1 +/- 1.3 photon counts/ms, p < 0.001). Flare values of apparently unaffected contralateral eyes (mean 3.9 +/- 1.1 photon counts/ms) did not differ from normal control eyes (p = 0.5). In the group of eyes with Fuchs' heterochromic uveitis, aqueous flare was comparable in eyes with and without secondary open angle glaucoma (11.9 +/- 2.5 versus 12.1 +/- 3.8 photon counts/ms, p = 0.9). CONCLUSION: The alteration of the blood-aqueous barrier in patients with Fuchs' heterochromic uveitis is unilateral and relatively mild, corresponding to the well-known clinical picture of the disease. Secondary open-angle glaucoma appears not to be associated with additional increase of aqueous flare. The unilaterality and the relatively homogeneous distribution of the degree of increased aqueous flare values support the clinical impression that Fuchs' heterochromic uveitis is a distinct clinical entity that should be differentiated from other variants of chronic anterior uveitis.     

糖尿病患者白内障与老年性白内障超声乳化术前后房水蛋白浓度变化的比较

目的　通过检测老年性白内障与糖尿病患者白内障超声乳化白内障吸除并人工晶体植入手术前后房水蛋白浓度的变化 ,评估该手术对眼血 -房水屏障的影响。方法　对 60例 (64眼 )老年性白内障患者及 5 2例 (5 6眼 )伴发糖尿病的白内障患者 (3 4眼非增殖型糖尿病性视网膜病变 ,2 2眼伴增殖型糖尿病性视网膜病变 ) ,应用激光闪光细胞检测仪 (Laserflarecellmeter ,LFCM )定量检测超声乳化白内障吸除并人工晶体植入术前、术后前房蛋白浓度。结果　术前 ,伴增殖型糖尿病性视网膜病变患者的前房蛋白浓度高于老年性白内障和非增殖型糖尿病性视网膜病变白内障患者 ,且差异有显著性 (P <0 0 5 ) ;而老年性白内障和非增殖型糖尿病性视网膜病变白内障患者间的房水蛋白浓度无明显差别。各组术后 1天、 7天及 3 0天的房水蛋白浓度均较术前高 ,并有显著性差别 (P <0 0 5 )。术后 90天时 ,老年性白内障和非增殖型糖尿病性视网膜病变白内障患者的房水蛋白浓度与术前无显著性差别 ;但伴增殖型糖尿病性视网膜病变患者的仍高于术前水平 ,且差异有显著性 (P <0 0 5 )。结论　对于老年性白内障患者与非增殖型糖尿病性视网膜病变的白内障患者 ,超声乳化吸除并折叠式人工晶体植入手术后眼血 -房水屏障功能均可在短期内恢复 ,而对     

Inflammation after implantation of hydrophilic acrylic,hydrophobic acrylic,or silicone intraocular lenses in eyes with cataract and uveitis: comparison to a control group

PURPOSE: To compare the course of inflammation after small-incision cataract surgery with implantation of 1 of 3 types of foldable intraocular lenses (IOLs) in eyes with uveitis. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: Seventy-four eyes with uveitis and cataract and 68 control eyes with cataract were prospectively selected to receive a foldable hydrophilic acrylic (Hydroview, Bausch & Lomb), hydrophobic acrylic (AcrySof, Alcon), or silicone (CeeOn 911, Pharmacia) IOL. All surgery was performed by the same surgeon using a standardized protocol: clear corneal incision, capsulorhexis, phacoemulsification, and in-the-bag IOL implantation. Preoperative and postoperative inflammation was evaluated by measuring aqueous flare preoperatively and 1, 3, 7, 28, 90, and 180 days after surgery using the Kowa FC-1000 laser flare-cell meter. All uveitic eyes were in remission for at least 3 months before surgery. RESULTS: In the uveitic eyes, there was no statistically significant difference in the postoperative course of flare and cell among the 3 IOL groups. Six months after surgery in uveitic eyes, flare values reached preoperative levels and the cell count was lower than preoperatively in all 3 IOL groups. Relative flare values were higher in the eyes with uveitis and a CeeOn 911 IOL; however, the difference between this group and the 2 acrylic IOL groups was not significant. CONCLUSIONS: There were no significant differences in inflammation after implantation of foldable IOLs in uveitic eyes. Although absolute flare values and cell counts in eyes with uveitis were higher than in control eyes, primarily because of a damaged blood-aqueous barrier (BAB), BAB recovery was similar between the 2 groups. The changes in the BAB indicate that foldable IOL implantation is safe in uveitic eyes.     

Short-term blood-aqueous barrier breakdown after implantation of the 1CU accommodative posterior chamber intraocular lens

PURPOSE: To quantify intraocular inflammation after phacoemulsification with implantation of an accommodative posterior chamber intraocular lens (IOL). SETTING: Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany. METHODS: Twenty cataractous eyes of 20 patients without preexisting blood-aqueous barrier (BAB) deficiencies or previous intraocular surgery were included in this study. The mean age of the patients was 64.6 years +/- 16.0 (SD). A single surgeon performed phacoemulsification through a superior sclerocorneal tunnel incision and implantation of a 1CU IOL (HumanOptics AG) though a 3.2 mm incision. The haptics of the single-piece acrylic 1CU lens are designed for anterior optic movement following ciliary muscle contraction. The postoperative treatment was standardized. Postoperative BAB breakdown was quantified by laser flare photometry (FC-1000, Kowa) at 1 day, 1 and 4 weeks, and 3 and 6 months. RESULTS: The mean aqueous flare was 6.3 photons/ms +/- 3.0 (SD) (range 4.0 to 12.2 photons/ms) 1 day postoperatively, with 64% of patients having normal aqueous flare values (<8.0 photons/ms). One week after surgery, the mean aqueous flare was 5.3 +/- 2.8 photons/ms (range 2.0 to 10.5 photons/ms). Four weeks postoperatively, aqueous flare was normal in all patients and remained stable below the normal limit for up to 6 months (mean 3.3 +/- 1.2 months; range 2.0 to 5.4 months). The number of aqueous cells did not increase at any follow-up and was normal in all eyes. No postoperative complications such as fibrin formation, synechias, macrophages on the IOL optic, or endophthalmitis were observed. CONCLUSIONS: Phacoemulsification with implantation of the 1CU accommodative IOL led to minimal and short-lasting BAB alteration. No signs of persistent inflammation or pigment dispersion were detected.