HEPARIN-MODIFIED LENSES FOR EYES AT RISK FOR BREAKDOWN OF THE BLOOD-AQUEOUS BARRIER DURING CATARACT-SURGERY

To determine the appropriateness of heparin-surface-modified (HSM) len ses in eyes at risk for breakdown of the blood-aqueous barrier, 36 con secutive patients with cataracts associated with chronic recurrent or past uveitis had extracapsular cataract extraction and insertion of an HSM posterior chamber one-piece intraocular lens (IOL). Examinations for implant precipitates (IPs), fibrin membranes, IOL synechias, and v isual outcome were done postoperatively. Results show that despite a r ecurrence of overt uveitis with keratic precipitates in 13 eyes (36.1% ), IPs were seen in only six eyes (16.6%) and were generally small and few in number. An acute postoperative fibrin reaction, which is relat ed to blood-aqueous barrier breakdown, occurred in nine eyes. Implant synechias were found in three eyes. We found that HSM provided a cell- free IOL surface in the majority of eyes at high risk for blood-aqueou s barrier breakdown and uveitis. Heparin surface modification does not prevent complications but tends to protect the lOL from inflammation changes that might otherwise occur.