98th Annual Meeting DOG 2000

P 805

Comparison between PMMA-and Heparin-surfaced intraocular lenses in patients with pseudoexfoliationsyndrome(PEX) – A lasertyndallometric study

S. Schumacher, M. J. M. Groh

Background: Impairement of the blood-aqueous barrier is a frequent finding in eyes with pseudoexfoliation syndrome(PEX) and cataract pre-and postoperatively. In this study we performed noninvasive quantification of aqueous flare to analyze the difference of postoperative blood-aqueous barrier breakdown after implantation of heparin-surfaced intraocular lenses (HepIOL) and PMMA-lenses (PMMA).

Patients and methods: Aqueous flare was quantitatively determined using a laser flare-cell meter (Kowa, FC-1000) preoperatively as well as 1, 3 and 5 days postoperatively in both groups.The flare values were indicated as photon counts per millisecond. Cataract surgery followed standardized procedures of phacoemulsification and was performed by one surgeon. In group 1 (6 women, 4 men; mean age 77,7 ± 5,7 years) heparin-surfaced intraocular lenses (Pharmacia 722C, 6,5 mm optical zone), and in group 2 (7 women, 4 men; mean age 74,2 ± 5,3 years) unsurfaced PMMA intraocular lenses (Pharmacia 808A, 6,5 mm optical zone) were implanted. Medical treatment was identical in both groups.

Results: Preoperative flare values were increased in both groups (16,8 ± 7,7 [PMMA] to 14,4 ± 9,2 [HepIOL]; p= 0,2 ). On the first postoperative day, flare values in eyes with PMMA were significantly higher (42,3 ± 21,3 [PMMA]) than in eyes with HepIOL (22,9 ± 18,9 [HepIOL]; p= 0,004 ).The difference between the flare values of the PMMA and those of HepIOL were not significant on the third postoperative day (22,9 ± 7,9 [PMMA] to 21,5 ± 21,7 [HepIOL]; p= 0,08).Tyndallometrically eyes with PMMA did have increased flare values on the fifth postoperative days compared with the group of HepIOL (21,2 ± 6,4 [PMMA] to 18,7 ± 22,6 [Hep IOL]; p= 0,01).

Comment: The breakdown of the blood-aqueous barrier is significantly reduced following heparin-surfaced lenses following intraocular lens implantation.This altered response to surgery speaks in favour of heparin- surfaced lenses in eyes with PEX.

Department of Ophthalmology, University of Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen / Supported by DFG ( SFB 539 )