[Minor effect of anti-inflammatory therapy on intraocular inflammation after minimally invasive phacoemulsification]

Abstract

In a prospective study, we examined the influence of different anti-inflammatory treatments on intraocular inflammation after minimally invasive cataract surgery.

Patients and methods: A total of 150 patients (39-88 years of age) underwent phacoemulsification using a temporal clear-corneal tunnel incision and implantation of a 5-mm PMMA posterior chamber. Each patient was randomly assigned to one of the following 5 treatment groups, each consisting of 30 patients: (1) diclofenac 0.1% unconserved eyedrops (DICun) pre- and postoperatively; (2) diclofenac 0.1% conserved eyedrops (DICco) pre- and postoperatively; (3) DICun postoperatively; (4) DICun pre- and postoperatively, plus dexamethasone-21-dihydrogenphosphate 0.1% eyedrops (DEXA) postoperatively; (5) DEXA postoperatively. The aqueous flare was measured pre- and postoperatively using the laser flare-cell meter.

Results: In group 1, the flare (in photon counts/ms) increased from 10.8 +/- 1.7 preoperatively to only 14.7 +/- 3.1 in the afternoon of the day of surgery. Even on day 1 postoperatively, the flare decreased to 9.3 +/- 0.9 and remained relatively constant on days 3 and 7 after surgery. There were no significant differences among the groups concerning flare means (P = 0.35) or time courses (P = 0.51).

Discussion: Anti-inflammatory treatment had no significant influence on the amount of postoperative aqueous flare. This is because of the fact that clear corneal phacoemulsification per se leads to an extremely low intraocular inflammation and thus makes the importance of anti-inflammatory pharmacotherapy relative.