AQUEOUS FLARE INTENSITY AFTER PHACOEMULSIFICATION IN PATIENTS WITH DIABETES-MELLITUS

Purpose: To prospectively compare the postoperative blood-aqueous barr ier breakdown induced by phacoemulsification and implantation of a hep arin-surface-modified poly(methyl methacrylate) intraocular lens in th e capsular bag in eyes with different stages of diabetic retinopathy ( DR) and a control group. Setting: St. Erik's Eye Hospital, Karolinska institute, Stockholm, Sweden. Methods: Aqueous flare intensity was mea sured preoperatively and 1 day 1 week: and 3 months postoperatively in 21 nondiabetic control patients (Group 1), 20 diabetic patients with no or mild-moderate nonproliferative DR (Group 2), and 19 diabetic pat ients with advanced DR (moderate-severe, severe nonproliferative, and proliferative DR) who were divided into groups: without clinically sig nificant macular edema (CSME), 7 eyes (Group 3), and with CSME, 12 eye s (Group 4). Results: Before surgery, flare intensity in Group 4 was s ignificantly higher than in Groups 1 and 2 (P < .05). Surgical trauma increased flare Values 1 day postoperatively in ail groups. One week a fter surgery, Groups 1 and 4 had flare intensity significantly higher than preoperatively (P < .05). Recovery of flare occurred 3 months pos toperatively in ail groups except Group 2, in which it occurred 1 week after surgery. One day postoperatively, only Group 4 had significantl y higher flare than Group 1 (P < .05). One week and 3 months after Sur gery, Group 4 had significantly higher flare intensity than Groups 1 a nd 2 (P < .05). The duration of phacoemulsification in Groups 2 and 4 was significantly longer than in Group 1 (P < .05). Operating time was significantly longer than in Group 1 only in Group 4 (P < .05). Concl usion: Eyes with advanced stages of DR and with CSME had the highest f lare intensity after cataract surgery.