Flare-cell meter measurement of inflammation after uneventful cataract surgery with intraocular lens implantation

Purpose: To determine whether intracapsular intraocular lens (IOL) implantation leads to less anterior chamber inflammation than sulcus implantation in eyes having uneventful extracapsular cataract extraction (ECCE). Setting: Division of Ophthalmology, University of Alicante, Spain. Methods: This study comprised 314 consecutive uneventful ECCEs with implantation of a rigid poly(methyl methacrylate) IOL performed by the same surgeon. Inflammation was assessed by evaluating aqueous flare and cells using a laser flare-cell meter. Flare and cells were measured in both eyes of all patients preoperatively and on postoperative days 1, 2, 3, 4, 5, 7, 10, and 15 and at the end of months 1, 2, and 3. In 131 eyes (41.7%), the haptics were in the bag and in 114 (36.3%), in the sulcus. In 69 eyes (22.0%), implantation was combined sulcus-bag. Results: Flare and cell counts were high on day 1 regardless of the haptic placement. The counts were highest in eyes with sulcus implantation (32.4 +/- 3.6 [SD] flare; 31.8 +/- 3.2 cells) and lowest in eyes with in-the-bag implantation (27.5 +/- 4.7 flare; 22.3 +/- 2.8 cells). One day postoperatively, the difference between groups in cell count was statistically significant but not in flare measurements. There were no significant between-group differences on day 2 and thereafter. Thirty days postoperatively, flare and cell counts were similar in all eyes. Conclusion: Inflammation after uneventful ECCE with IOL implantation resolved within about 3 months of surgery, with flare and cell counts similar to those preoperatively. There was a small but detectable difference in flare and cell counts on the first day after surgery based on haptic location.