Flaremetric evaluation of blood-aqueous barrier breakdown in diabetic patients after phacoemulsification and intraocular lenses with or without heparin-coated surface implantation Original research study

Main Article Content

Anna Górnik
Piotr Jurowski

Abstract

Background: This study compared the intensity of blood-aqueous barrier breakdown in diabetic patients after phacoemulsification with heparin surface-modified and non-modified intraocular lens (IOL) implantation.


Material and methods: In this prospective trial, 68 diabetic patients were enrolled and divided into two groups: 33 patients with heparin surface-modified IOL implants (group 1) and 35 patients with standard hydrophobic IOL implants (group 2). Blood-aqueous barrier breakdown was assessed using a Laser Flare Meter 1 day, 7 days, 14 days, 1 month, and 3 months postoperatively.


Results: On postoperative days 1 and 7, the mean flare value was significantly higher in group 2 compared with group 1. On day 14, the mean flare value in both groups was similar and then higher in group 2.


Conclusions: The implantation of foldable heparin-coated IOLs led to a lower intensity and faster recovery of blood-aqueous barrier breakdown postoperatively.

Article Details

How to Cite
1.
Górnik A, Jurowski P. Flaremetric evaluation of blood-aqueous barrier breakdown in diabetic patients after phacoemulsification and intraocular lenses with or without heparin-coated surface implantation. Ophthatherapy [Internet]. 2020May23 [cited 2020Aug.10];7(2):85-9. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/1034
Section
Diagnostics

References

1. Apple DJ. Influence of intraocular lens material and design on postoperative intracapsular cellular reactivity. Trans Am Ophth Soc. 2000; 98: 257-83.
2. Langwińska-Wośko E, Rowiński M, Bełzecka-Majszyk A et al. Soczewki wewnątrzgałkowe tylnokomorowe – przegląd asortymentu ze szczególnym uwzględnieniem soczewek zwijalnych. Okulistyka. 2001; 3: 17-22.
3. Huang Q, Cheng GP, Chiu K, et al. Surface Modification of Intraocular Lenses. Chin Med J. 2016; 129: 206‑14.
4. Kang S, Kim M-J. Comparison of clinical results between heparin surface modified hydrophilic acrylic and hydrophobic acrylic intraocular lens. Eur J Ophthalmol. 2008; 18(3): 377-83.
5. Sawa M. Laser flare-cell photometer: principle and significance in clinical and basic ophthalmology. Jpn J Ophthalmol. 2017; 61(1): 21-42.
6. Ladas JG, Wheeler NC, Morhun PJ et al. Laser flare-cell photometry: methodology and clinical applications. Surv Ophthalmol. 2005; 50(1): 27-47.
7. Percival P. Use of heparin-modified lenses in high-risk case for uveitis. Dev Ophthalmol. 1991; 22: 80-3.
8. Sanders DR, Kraft M. Steroidal and nonsteroidal anti-inflammatory agents; effect on postsurgical inflammation and blood-aqueous humor barrier breakdown. Arch Ophthalmol. 1984; 102(10): 1453-6.
9. Philipson B, Fagerholm P, Calel B et al. Heparin surface modified intraocular lenses. Three-month follow-up a randomized, double- masked clinical trial. J Cataract Refract Surg. 1992; 71-8.
10. Jurowski P. Ocena czynników stabilizujących struktury wewnątrzgałkowe przed urazem termicznym w czasie pracy fakoemulsyfikatora w badaniach doświadczalnych u królików. Rozprawa habilitacyjna. 1997.
11. Jurowski P. Rola tlenku azotu w regulacji biochemicznych procesów wewnątrzgałkowych. Okulistyka. 1998, 1: 38-40.
12. Jurowski P, Goś R, Piasecka G. Nitric oxide levels in aqueous humor after lens extraction and poly(methyl methacrylate) and foldable acrylic intraocular lens implantation in rabbit eyes. J Cataract Refract Surg. 2002; 28(12): 2188-92.
13. Tang J, Kern TS. Inflammation in diabetic retinopathy. Prog Retin Eye Res. 2011; 30(5): 343-58.
14. Del Vecchio PJ, Bizios R, Holleran LA et al. Inhibition of human scleral fibroblast proliferation with heparin. Invest Ophthalmol Vis Sci. 1988; 29: 1272-6.
15. Tognetto D, Ravalico G. Inflammatory cell adhesion and surface defects on heparin-surface-modified poly(methyl methacrylate) intraocular lenses in diabetic patients. J Cataract Refract Surg. 2001; 27(2): 239-44.
16. Liu T, Hu AH, Hu QJ et al. Objective assessment of the inflammatory reaction in foldable heparin surface-modified hydrophilic acrylic intraocular lens. Int Eye Sci. 2016; 16(1): 11-3.
17. Ravalico G, Tognetto D, Baccara F. Heparin surface modified intraocular lens implantation in eye with pseudoexfoliation syndrome. J Cataract Refract Surg. 1994; 20(5): 543-9.
18. Shah SM, Spalton DJ. Comparison of the postoperative inflammatory response in the normal eye with heparin Surface-modified and poly (methyl methacrylate) intraocular lenses. J Cataract Refract Surg. 1995; 21(5): 579-85.
19. Mester U, Strauss M, Grewing R. Biocompatibility and blood-aqueous barrier impairment in at-risk eyes with heparin-surface-modified or unmodified lenses. J Cataract Refract Surg. 1998; 24(3): 380-4.
20. Pande M, Shah SM, Spalton DJ. Correlations between aqueous flare and cells and lens surface cytology in eyes with poly(methyl methacrylate) and heparin-surface-modified intraocular lenses. J Cataract Refract Surg. 1995; 21(3): 326-30.
21. Krall EM, Arlt EM, Jell G et al. Intraindividual aqueous flare comparison after implantation of hydrophobic intraocular lenses with or without a heparin-coated surface. J Cataract Refract Surg. 2014; 40(8): 1363-70.