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Persistence of Inflammation After Uncomplicated Cataract Surgery: A 6-Month Laser Flare Photometry Analysis

Abstract

Purpose

To evaluate, by laser photometry, the persistency of anterior chamber flare after uneventful phacoemulsification in asymptomatic patients with no signs of inflammation on slit lamp examination.

Method

Seventy-five patients previously enrolled in a randomized clinical trial that evaluated inflammation after uneventful phacoemulsification in eyes treated with dexamethasone 0.1% ophthalmic suspension (group 1) or bromfenac 0.09% ophthalmic solution (group 2) for 2 weeks. Anterior chamber inflammation was investigated by laser flare photometry. At 30 days after surgery, laser flare showed persistently elevated values. For this reason, patients were further analyzed at 3 and 6 months. Additionally, optical coherence tomography was used to measure the central macular thickness (CMT) and to assess for postoperative pseudophakic macular edema.

Results

When compared to preoperative values, laser flare photometry demonstrated persistent ocular inflammation at postoperative days 90 and 180 in group 1, but not in group 2. Laser flare values showed a significant reduction in group 2 compared to group 1 throughout all the follow-up (p < 0.001). The increase in mean CMT at days 90 and 180 with respect to baseline was statistically significant in group 1 but not in group 2, in which it decreased to levels similar to preoperative value. Group 1 showed a higher increase in mean CMT compared to group 2 throughout all the follow-up (p < 0.001). The proportion of patients that developed pseudophakic cystoid macular edema (CME) was 14% (n = 5) and 0% (n = 0) in group 1 and group 2, respectively (p = 0.02). The bivariate analysis demonstrated a positive correlation between laser flare and CMT values in group 1 but not in group 2.

Conclusion

Anterior chamber inflammation persists for more than 30 days in a significant proportion of patients after uncomplicated cataract surgery and may be responsible for late onset of cystoid macular edema cases.

Trial Registration

ClinicalTrials.gov identifier, NCT03317847.

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Acknowledgements

The authors thank all patients and participants for kindly contributing to the study.

Funding

The study was sponsored by the Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy, who also funded the journal’s Rapid Service Fee.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Michele De Maria, Marco Coassin, Valentina Mastrofilippo, Luca Cimino, Danilo Iannetta, and Luigi Fontana have nothing to disclose.

Compliance with Ethics Guidelines

The study protocol was approved by the local ethics committee (Comitato Etico dell’Area Vasta Emilia Nord) and the trial was conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all patients.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Corresponding author

Correspondence to Luigi Fontana.

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Cite this article

De Maria, M., Coassin, M., Mastrofilippo, V. et al. Persistence of Inflammation After Uncomplicated Cataract Surgery: A 6-Month Laser Flare Photometry Analysis. Adv Ther 37, 3223–3233 (2020). https://doi.org/10.1007/s12325-020-01383-1

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  • DOI: https://doi.org/10.1007/s12325-020-01383-1

Keywords

  • Cataract surgery
  • Laser flare photometry
  • Non-steroidal anti-inflammatory drugs