Early objective assessment of intraocular inflammation after phacoemulsification cataract surgery

Purpose: To evaluate the time course of blood-aqueous barrier (BAB) disturbance in the early period after small-incision cataract surgery. Setting: Department of Ophthalmology, Vienna University, Vienna, Austria. Methods: In a prospective study, 15 eyes of 15 patients with age-related cataract had small-incision cataract surgery by phacoemulsification with intraocular lens implantation. Care was taken to minimize trauma to the uvea during surgery. Postoperative inflammation was assessed by measuring aqueous flare and cell count with a laser flare-cell meter. Postoperative measurements were performed hourly for the first 6 hours, every 2 hours until 12 hours, every 4 hours until 40 hours, and every 8 hours until 56 hours. Results: The time course of aqueous flare and cell count differed significantly among patients. The peak inflammatory response in most cases was 1 hour after surgery, with the response decreasing thereafter. The pattern of the time course was classified into subgroups defined by the presence and size of an initial spike immediately after surgery and the intensity of the subsequent inflammatory reaction. A slight increase in flare and cells was seen in the morning hours of the first postoperative day. Conclusions: Acute BAB disturbance within the first 48 hours after small-incision cataract surgery showed high interpatient variability. However, many differences were not detectable 1 day after surgery. (C) 2003 ASCRS and ESCRS.