Postoperative inflammation: Extracapsular cataract extraction versus phacoemulsification

Purpose: To quantitatively compare postoperative inflammation after extraca psular cataract extraction (ECCE) with that after phacoemulsification in an Asian population. Setting: Singapore National Eye Center, Singapore. Methods: In this prospective, randomized, double-masked clinical trial, pat ients having cataract surgery were randomized to receive ECCE (n = 16) or p hacoemulsification (n = 18), Diabetics were excluded. Two surgeons performe d both types of surgery and implanted a 6.0 mm optic intraocular lens. infl ammation was assessed qualitatively by slitlamp grading of cells and flare and quantitatively using the Kowa flare meter. One independent postoperativ e investigator performed the slitlamp examination and laser flare meter rea dings. Results: The ECCE and phacoemulsification groups were comparable (P > .05) in age, sex, ethnicity, and preoperative flare levels. The combined slitlam p inflammatory scores (anterior chamber cells and flare) and mean laser fla re meter readings showed the ECCE group had significantly higher mean flare measurements than the phacoemulsification group at days 4 (P = .0012), 8 ( P = .0013), 15 (P = .0013), 30 (P = .0004), and 60 (P = .0164). Flare level s in the ECCE group returned to preoperative values by the second month; th e phacoemulsification group achieved preoperative levels by 1 month. The cl inical inflammatory assessment score correlated closely to the flare level readings. Conclusion: Phacoemulsification induced less inflammation than ECCE, with t he difference most marked in the first month after surgery. (C) 1999 ASCRS and ESCRS.