Inflammation after sclerocorneal versus clear corneal tunnel phacoemulsification

OBJECTIVE: To compare the postoperative inflammation after phacoemulsification followed by intraocular lens (IOL) implantation by means of sclerocorneal versus clear corneal tunnel incision. DESIGN: Randomized controlled clinical trial. PARTICIPANTS: One hundred eyes of 100 patients were examined at a German University eye hospital. INTERVENTION: One hundred eyes with cataract necessitating phacoemulsification with posterior chamber IOL implantation were randomly assigned to receive a temporal sclerocorneal or clear corneal tunnel incision by a single surgeon. MAIN OUTCOME MEASURES: Preoperative and postoperative inflammation was evaluated by measurement of flare using laser flare photometry. Statistical inference was mainly based on nonparametric group comparisons by use of two sample Wilcoxon tests. RESULTS: Mean anterior chamber flare in the group with sclerocorneal tunnel increased from 7.5 photon counts/ms preoperatively to 19.6 at 6 hours postoperatively and decreased to 11.1 (day 1), 11.7 (day 2), 11.6 (day 3), and 9.2 (5 months) during the postoperative course. The mean flare in the clear corneal tunnel incision group increased from 7.7 preoperatively to 12.9 at 6 hours postoperatively and then decreased to 9.2 (day 1), 9.8 (day 2), 9.1 (day 3), and 9.2 (5 months). Individual postoperative flare changes were significantly lower in the clear corneal tunnel group at the day of surgery (P<0.0001), as well as at day 1 (P = 0.0011), day 2 (P = 0.0079), and day 3 (P = 0.0020). After 5 months, no statistically significant difference was found. CONCLUSIONS: After phacoemulsification and foldable IOL implantation, postoperative alteration in the blood-aqueous barrier was statistically significantly lower with the clear corneal tunnel incision group compared with the sclerocorneal incision group, in the first 3 days postoperatively.     

Effect of incision size and site on corneal endothelial changes in cataract surgery.

PURPOSE: To compare endothelial damage induced by different cataract incision sites and sizes using specular microscopy. SETTING: Department of Ophthalmology, Hospital of San Donà di Piave, Venice, Italy. METHODS: Eighty-one eyes having phacoemulsification were randomly assigned to 1 of 3 groups of 27 eyes each: 3.5 mm clear corneal incision (CCI) with silicone foldable intraocular lens (IOL) implantation; 5.5 mm sutured CCI with poly(methyl methacrylate) (PMMA) IOL implantation; 5.5 mm scleral tunnel with PMMA IOL implantation. All incisions were centered at the 120-degree semimeridian; that is, they were superotemporal in right eyes and superonasal in left eyes. Noncontact specular microscopy was performed in the center and at the 12 o'clock position preoperatively as well as 1 week and 1, 3, and 12 months postoperatively. The endothelial cell density, mean cell area, cell size variation coefficient, percentage of hexagonality, and corneal thickness were considered. RESULTS: Progressive endothelial cell loss and an increase in mean cell area occurred in all groups during the follow-up. The cell loss percentages relative to the endothelial center appeared similar among the groups and slightly although not significantly lower in the scleral tunnel group. The scleral tunnel group had a statistically significant lower cell loss percentage at the 12 o'clock position than the 2 CCI groups at all follow-ups. CONCLUSIONS: The scleral tunnel group had less postoperative endothelial damage than the 2 CCI groups, with a statistically significant difference at the 12 o'clock position. This is probably because the scleral tunnel incision is placed more posteriorly and therefore induces less direct and indirect endothelial trauma.     

抗青光眼滤过术后患者白内障超声乳化吸除及人工晶状体植入术

目的：探讨抗青光眼滤过术后白内障患者进行白内障超声乳化吸除及人工晶状体植入术的手术切口选择和临床效果。方法：32例（41只眼）青光眼滤过术后的白内障患者,采用上方透明角膜隧道切口和避开滤过泡的巩膜隧道切口行白内障超声乳化吸除,植入折叠式人工晶状体24只眼,硬性人工晶状体17只眼。结果：全部白内障术后病例视力有不同程度的提高,视力≥0．5者达75．6％。采用透明角膜隧道切口和巩膜隧道切口术后患者的眼压和滤过泡改变无差异性,术后随访平均5个月,平均眼压较术前增加1．59mmHg(1mmHg=0.133kPa),差异无显著性。结论：对抗青光眼滤过术后白内障患者,采用透明角膜和巩膜隧道切口行白内障超声乳化吸除及人工晶状体植入术,可提高视力,同时可保持原有的滤过功能。     

One-site versus 2-site phacotrabeculectomy:A randomized study

Purpose:To compare 1-site and 2-site combined phacoemulsitication with foldable intraocular lens (IOL) implantation and trabeculectomySetting:El-Maghraby Eye Hospital, Jeddah, Saudi Arabia.Methods:Seventy-six eyes with coexisting cataract and glaucoma were randomwith phacoemulsification and foldable IOL implantation through the same (1-site group) or a separate; temporal clear corneal incision (2-site group) Postoperative evaluation included visual acuity, intraocular pressure, (IOL bleb) assessment, and number of antiglaucoma medications. Follow-up 12 to 18 months.Results:Mean preoperative IOP was 28.1 mm Hg ± 7.1 (SD) in the 2-site group and 26.2 ± 6.5 mm Hg in the 1-site group. At 6 months postoperatively mean IOP was 16.9 ± 4.3 and 16.8 ± 3.8 mm Hg, respectively (P = () and at 12 months, 3.3 and 19.1 ± 3.1 mm Hg, respectively (P = 044). Twenty-three of 39 eyes in the 2-site group and 14 of 37 (38%) in the T-site group had clinically apparent filtering blebs at 12 months (P = .065). Postoperative astigmatic change and complications were comparable.Conclusion:Mitomycin-C trabeculectomy superiorly combined with separate temporalclear corneal phacoemulsification provided 1 year IOP control comparable to that with single-incision (1-site) combined cataract and glaucoma surgery.     

Combined cataract surgery, intraocular lens implantation, and viscocanalostomy.

PURPOSE: To describe 2 techniques of combined viscocanalostomy and phacoemulsification and report the results. SETTING: Gimbel Eye Centre, Calgary, Alberta, Canada. METHODS: Combined viscocanalostomy, phacoemulsification, and intraocular lens implantation was performed in 83 eyes. A shared scleral incision was made in 46 eyes and a clear corneal incision separate from the viscocanalostomy site, in 37 eyes. A retrospective review of these cases was performed. RESULTS: Intraocular pressure (IOP) was significantly lower in both groups 2 and 8 weeks and 6 months postoperatively. The decline in IOP postoperatively over time was also comparable. There were no cases of hypotony, choroidal detachment, filtrating bleb, or postoperative cystoid macular edema in either group. Complications included IOP spikes in 2 eyes in the shared-incision group at 1 day (to 43 and 30 mm Hg, respectively). In early shared-incision cases, there was 1 obvious Descement's puncture in 1 eye and a torn scleral flap requiring extra suturing in another eye. CONCLUSION: Combined viscocanalostomy, cataract extraction, and IOL implantation was safe and efficacious in lowering IOP whether a shared scleral incision or a separate clear corneal incision was used for phacoemulsification.     

角巩膜隧道切口超声乳化白内障吸除 折叠式人工晶状体植入术临床观察

目的 探讨角巩膜隧道切口超声乳化白内障吸除折叠式人工晶状体植入术的临床疗效。方法 对86例（107只眼）老年性白内障患者,采用角膜上方膜缘后0.5mm做长约4mm角巩膜隧道切口的方法,行超声乳化白内障吸除术,同时植入丙烯酸酯类三片式折叠式人工晶状体。结果 术后1d、1周、1个月和3个月裸眼或矫正视力≥0.5者分别为62.6%、76.6%、92.5%和88.8%。结论 角巩膜隧道切口超声乳化白内障吸除折叠式人工晶状体植入术兼有巩膜隧道小切口和透明角膜小切口手术的优点,术后疗效满意。     

超声乳化在青光眼滤过术后白内障的应用

目的:探讨超声乳化联合人工晶状体植入术治疗青光眼滤过术后白内障的临床效果。方法:对35例41眼抗青光眼滤过术后白内障采用颞侧透明角膜的白内障超声乳化吸出术联合折叠人工晶状体植入术,术后观察视力、并发症、眼压和滤过泡的改变。结果:白内障术后的视力均有不同程度的提高,术后随访1～2a,眼压、滤过泡无明显改变。结论:颞侧透明角膜白内障超声乳化联合人工晶状体植入术治疗青光眼滤过术后白内障是安全有效的治疗方法。     

透明角膜切口白内障超声乳化联合青光眼手术的疗效分析

目的:观察透明角膜切口白内障超声乳化人工晶状体植入联合小梁切除术(以下简称超声乳化三联术)治疗青光眼合并白内障的临床疗效和安全性。方法:回顾性分析使用透明角膜切口超声乳化三联术治疗各种类型的青光眼合并白内障患者127例(128眼)手术前、后的视力和眼压,手术并发症和滤过泡情况。结果:术后视力迅速恢复,矫正视力较术前明显提高,随访6mo～2a,113眼≥0.5(88.3%);眼压较术前明显降低,11眼术后眼压<20mmHg,16眼加滴1～2种降压药后眼压控制满意且稳定。术后并发症少,功能性滤过泡83.6%。结论:透明角膜切口超声乳化白内障吸除人工晶状体植入联合小梁切除术治疗青光眼合并白内障,不但能良好地控制眼压,迅速恢复视力。而且并发症少,手术适应证广,在白内障青光眼并存情况下采用超声乳化三联手术是安全、有效、可靠的治疗方法。     

Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients

PURPOSE: To evaluate long-term IOP control after sutureless clear corneal phacoemulsification in eyes with preoperatively controlled glaucoma. SETTING: Institutional study. METHODS: The charts of 345 patients who had uneventful sutureless clear corneal phacoemulsification with acrylic foldable lens (IOL) implantation were retrospectively reviewed. Included were 58 patients with medically controlled open-angle glaucoma and 287 normal controls. Follow-up was 1 to 2 years. Outcome measures were postoperative IOP and number of glaucoma medications. RESULTS: Postoperatively, there was an insignificant decrease in IOP in the glaucoma group; the mean decrease was 1.5 mm Hg +/- 4.4 (SD) at 12 months and 1.9 +/- 4.9 mm Hg at 24 months. The mean number of medications decreased significantly at 12 months (0.53 +/- 0.86) and at 24 months (0.38 +/- 0.9) (P=.04). The control group also had a significant decrease in IOP, with a mean decrease of 0.72 +/- 3.7 mm Hg at 12 months (P=.01) and 1.33 +/- 3.2 mm Hg at 24 months (P<.0001). The decrease in IOP was more pronounced in eyes with a higher preoperative IOP in both the glaucoma and control groups. CONCLUSIONS: These findings suggest that sutureless clear corneal phacoemulsification with foldable acrylic IOL implantation is a relatively simple and efficient surgical option in patients with cataract and well-controlled glaucoma. The approach combines long-term IOP control with fewer medications and leads to rapid visual rehabilitation.     

非球面和球面人工晶状体植入术后视功能观察

目的 分析白内障患者术前角膜散光情况评估经不同位置透明角膜切口行超声乳化术后的角膜散光变化情况.方法 218例(295只眼)白内障患者分为三组,第一组选择颞侧切口,第二组选择颞上方切口,第三组选择上方切口,三组患者通过透明角膜切口行白内障超声乳化及折叠式后房型人工晶体植入术.术前及术后一周、一月、三月分别检测患者角膜散光情况,并通过Holladay-Cravy-Koch方法 计算术源性散光.结果 术前角膜散光0.5至1.5D的占60.68%,大于等于1.5D的占11.86%,顺归散光占29.49%,逆归散光占51.19%,其余为斜轴散光.术后三次随访颞侧切口组的术源性散光最低,上方切口组的术源性散光最高,具有统计学差异(P<0.05).另外,在上方切口组中发现患者术后角膜散光有向逆归散光转变的趋势.结论 白内障患者术前大多存在小于1.5D的角膜散光.在白内障术后早期阶段,颞侧透明角膜切口引起的术源性散光较小,而上方透明角膜切口不仅可引起较显著的术源性散光,并且术后角膜散光有向逆归散光转变的趋势.

Abstract：

Objective To analyze the corneal astigmatism before cataract surgery and evaluate the astigmatism changes after cataract surgery performed using clear corneal incisions with different locations.Methods: This randomized prospective clinical study comprised 295 eyes of 218 patients having phacoemulsification and implantation of foldable intraocular lens through a corneal tunnel incision. Patients were randomly divided into three groups depending on the different locations of the incision: temporal, superotemporal and superior. Corneal topography was performed preoperatively and 1 week, 1 month, and 3 months postoperatively. Surgically induced changes were calculated by vector analyses using the Holladay-Cravy-Koch method. Results: Preoperatively, in 60.68% of eyes, corneal astigmatism was between 0.5 and 1.5 diopters (D) and in 11.86%, it was 1.5 D or higher. Meanwhile, about 29.49 percent of eyes had with-the-rule (WTR) astigmatism, while 51.19% had against-the-rule (ATR) astigmatism, and the others had oblique astigmatism. At three follow-up visits postoperatively, the mean magnitude of surgically-induced astigmatism (SIA) was lowest in the temporal incision group and highest in the superior incision group. In addition, an ATR shift was found in the superior incision group. Conclusions: Corneal astigmatism less than 1.5 D was present in most cataract surgery candidates. Cataract surgery using temporal clear corneal incision induced significantly less SIA in the early postoperative period. Superior incision may lead to an ATR astigmatism shift.     

透明角膜切口超声乳化折叠人工晶状体植入术138例分析

目的 探讨透明角膜小切口白内障超声乳化及折叠式人工体植入术的方法及疗效。方法 对１３８例（１６８只眼）白内障病人进行透明角膜切口的超声乳化白内障摘出术,全部病 列均采用表面麻醉及植入折叠式人工晶状体,术后观察手术反应、视力和并发症。结果随访第１天的;裸眼视力在０．４以上者有１５７眼,占９３．４５％,术后１周和手术后１个月的矫正视力在０．５以上者分别为１５２眼（９０．４８％）和１６０眼（９５．４     

高度近视白内障小切口超声乳化摘除术

目的：探讨经透明角膜隧道对高度近视白内障患者行超声乳化摘除术的可行性及手术技巧。方法：对２１６例高度近视合并白内障患者,经角膜缘隧道切口行超声乳化吸出,并植入软性或硬性人工晶体。对超声乳化能量、时间、负压及术后视力、散光及并发症进行观察。结果：采用较低能量、中度真空压力及中低档流速行超声乳化吸出,术后视力≥０．８者１４３例,≥０．５者４９例。术前近视力≥０．８者,术后远视力常较佳。术前及术后散光３．０ｍｍ切口组无统计学差异,５．５ｍｍ切口组有统计学差异。未见明显严重并发症。结论：透明角膜超声乳化联合软性或硬性人工晶体植入,是高度近视白内障较理想的手术方式。     

白内障超声乳化吸出人工晶状体植入术后24小时眼压变化的临床分析

目的分析白内障超声乳化吸出人工晶状体植入术后24h眼压变化。方法选取125例（140只眼）进行白内障超声乳化吸出植入折叠式人工晶状体术患者,术中无并发症,在术前、术后4～8h、术后24h测眼压进行观察和分析。结果术后4～8h为眼压升高峰值期,眼压升高发生率为32.14%,眼压≥24mmHg为10.71%,最高值可达到40mmHg,术后24h后眼压逐渐下降。结论术后眼压的变化与粘弹剂的应用、核硬度及超声能量等因素有关。要重视白内障超声乳化术后早期眼压的监测,特别是术后4～8h的眼压测量。术中应该注意选择优质的粘弹剂或者合理的结合使用,并早期进行眼压观察。     

Phacoemulsification with transpupillary silicone oil removal and lens implantation through a corneal incision using topical anesthesia

PURPOSE: To evaluate phacoemulsification combined with transpupillary silicone oil removal and foldable intraocular lens (IOL) implantation through a single corneal incision and planned posterior capsulorhexis after pars plana vitrectomy using topical anesthesia. SETTING: Department of Ophthalmology, University of Bari, Bari, Italy. METHODS: This noncomparative nonrandomized noncontrolled interventional case series comprised 34 consecutive patients (34 eyes). The mean age of the 25 men and 9 women was 54.4 years +/- 13.3 (SD). A mean of 8.2 +/- 9.4 months after silicone oil injection, patients had phacoemulsification with transpupillary silicone oil removal and foldable acrylic IOL implantation through a single corneal incision and a planned posterior capsulorhexis under topical anesthesia. Patients were operated on by the same surgeon. Visual acuity, the frequency of retinal redetachment, secondary cataract and vitreous hemorrhage formation, subjective pain and discomfort, the duration of surgery, and intraocular pressure (IOP) were noted. The mean follow-up was 9.4 +/- 5.1 months (range 4 to 21 months). RESULTS: Vision improved or stabilized in 88.2% of eyes. Retinal redetachment occurred in 4 eyes (11.8%) and transient vitreous hemorrhage in 1 (2.9%). All patients reported minimal discomfort during the procedure. The mean duration of surgery was 17 +/- 4 minutes. There was no significant intraoperative or postoperative IOP variation. CONCLUSIONS: Combined phacoemulsification, transpupillary silicone oil removal, and IOL implantation through a single corneal incision under topical anesthesia was safe and effective. In general, the visual outcomes were good with improvement in visual acuity.     

Anterior chamber maintainer versus viscoelastic material for intraocular lens implantation: case-control study

PURPOSE: To compare best corrected visual acuity (BCVA) and intraocular pressure (IOP) in eyes that had a foldable intraocular lens (IOL) implanted with the use of an anterior chamber maintainer (ACM) in 1 eye and hyaluronate 3.0% (Vitrax) viscoelastic material in the other eye. SETTING: Private practice in a large urban center. METHODS: Sixty-six eyes of 33 patients had consecutive bilateral cataract extraction by the same surgeon using an identical temporal approach, clear corneal phacoemulsification, and implantation of an Allergan SI-40NB or SA-40NB IOL through an injection delivery system. The first operative eye was arbitrarily assigned to the ACM or Vitrax group, while the fellow eye received the opposite technique. Patients with coexisting ocular pathology that could influence the measured outcomes (eg, glaucoma, age-related macular degeneration) were excluded. Patients were evaluated preoperatively and 1 day and 3 to 6 weeks postoperatively. RESULTS: No serious intraoperative or postoperative complications were reported. The only statistical difference in BCVA or IOP was on the first postoperative day, when the mean IOP was approximately 2 mm Hg lower in the ACM group than in the Vitrax group. CONCLUSION: The use of an ACM for implantation of an injected 3-piece silicone IOL may lower IOP on the first postoperative day.     

白内障超声乳化术3.2mm透明角膜切口术源性散光的分析

目的:计算并比较不同位置3.2mm透明角膜切口白内障超声乳化吸出联合人工晶状体植入术的手术源性散光(surgery induced astigmatism,SIA)的度数,分析切口对角膜曲率的影响。方法:将88例100眼随机分为A,B两组,A组做颞侧(9∶00或者3∶00方位)透明角膜3.2mm斜形切口,B组做上方12∶00方位透明角膜斜形切口,行白内障超声乳化吸出联合折叠人工晶状体植入术,测量术前和术后3mo的角膜曲率,用矢量分析法计算SIA度数,比较两组SIA度数的差异,同时分别比较切口所在子午线、与切口垂直子午线术前和术后角膜曲率的变化。结果:两组平均SIA度数比较,差异无显著性(P=0.483),切口所在子午线术前和术后角膜曲率比较,差异有显著性(P=0.006),而与切口垂直子午线的术前和术后角膜曲率比较差异无显著性(P=0.084)。结论:3.2mm透明角膜切口SIA的度数与切口位置无明显关系,切口对所在子午线角膜曲率有松解作用,对与切口垂直子午线角膜曲率无明显影响,矢量公式法计算所得的SIA值在散光型人工晶状体植入术中提供了重要的参考价值。     

抗青光眼滤过术后白内障摘除术对眼内压长期影响的临床观察

目的探讨抗青光眼滤过术后白内障摘除术对眼内压的长期影响。方法对抗青光眼滤过术后白内障患者69例69眼随机分为三组,分别采用颞侧角巩膜缘切口白内障囊外摘除及人工晶状体植入术(简称ECCE组)(18例18眼)、颞侧角巩膜缘隧道切口超声乳化白内障吸除及人工晶体植入术(简称角巩膜缘超声乳化组)(25例25眼)和上方透明角膜切口超声乳化白内障吸除及折叠式人工晶体植入术(简称透明角膜超声乳化组)(26例26眼),术后平均随访26个月,分别观察眼压和视力并进行比较。结果ECCE组、角巩膜缘超声乳化组、透明角膜超声乳化组术后最后一次随访时平均眼压升高分别为2.75mmHg,1.82mmHg和1.68mmHg,与术前比较,差异均无统计学意义(>0.05);视力改善分别为12眼(70.6%)、23眼(92.0%)和24眼(92.3%);ECCE组与角巩膜缘超声乳化组和透明角膜超声乳化组比较,术后效果低于两种超声乳化组,差异有统计学意义(<0.05),两种超声乳化组间比较,差异无统计学意义(>O.05)。结论抗青光眼滤过术后三种白内障摘除术术后眼压均可有效控制,视力改善,超声乳化白内障吸除术尤其是经透明角膜切口折叠式人工晶体植入术术后长期对眼压影响小,视力恢复快,是目前此类白内障手术的最佳术式。     

角膜地形图引导下白内障手术切口对角膜散光的矫正

目的:比较不同位置和形态的手术切口对白内障摘除术后角膜散光及裸眼视力的影响。方法:选取术前角膜散光值>1.00D的白内障患者43例52眼,将患者随机分成两组,A组患者采用超声乳化白内障吸除联合人工晶状体植入术,手术切口为位于上方10∶30～11∶30的透明角膜隧道切口。B组患者采用手法碎核白内障摘除联合人工晶状体植入术,其中角膜散光值为1.00～2.00D的患者,切口为位于角膜最大屈光度径线的直线形巩膜隧道切口,长度为6.0～7.0mm,角膜散光值>2.00D的患者,在上述直线形切口对侧角膜缘处,另作一弧形板层松解切口。分别于术后2wk,3mo随访患者,检查裸眼视力及行角膜地形图检查。结果:B组患者术后2wk,3mo裸眼视力好于A组。B组患者术后角膜散光度在术后2wk,3mo时均小于A组。结论:位于角膜最大屈光度径线的6.0～7.0mm直线形巩膜隧道切口,及此切口联合作对侧弧形板层松解切口均能有效矫正白内障术前存在的角膜散光,能够使患者获得更好的术后裸眼视力。     

超声乳化白内障吸除联合青光眼黏弹剂小管扩张术的临床疗效观察

目的　评价超声乳化白内障吸除折叠式人工晶状体 (IOL)植入联合黏弹剂小管扩张术(V P术 )的安全性和有效性。方法　收集 2 8例 (30只眼 )因白内障合并原发性开角型青光眼行V P术患者 (V P组 )的临床资料 ,总结和分析患者的视力、眼压及手术并发症的发生情况 ,并与行超声乳化白内障吸除折叠式IOL植入联合小梁切除术 (T P术 )的 2 7例 (2 8只眼 )白内障合并青光眼患者 (T P组 )进行比较。术后随访时间 6个月。结果　术后 6个月 ,V P组平均眼压为 (14 6 5± 2 70 )mmHg(1mmHg=0 133kPa) ,较术前降低 10 33mmHg ,差异有显著意义 (P =0 0 0 0 ) ;术后 1周、1个月、6个月两组降眼压效果比较 ,差异均无显著意义 (P =0 6 6 1,0 381,0 5 2 6 )。V P组术后 1周、1个月、6个月最佳矫正视力≥ 0 5的眼数占随访眼数的百分比分别为 6 2 1% (18/ 2 9)、71 4 % (2 0 / 2 8)及 80 0 % (2 4 /30 ) ,与T P组比较 ,差异均无显著意义 (P =0 6 2 1,0 70 2 ,0 893)。V P组术中并发症包括小梁网Descemet膜穿破和Schlemm管刺破 (各 2只眼 ) ,术后 2 4h一过性眼压升高 (4只眼 ) ,无其他严重并发症。T P组术后并发症包括前房明显炎性反应 (6只眼 ) ,少量前房出血和脉络膜脱离 (各 1只眼 )。结论　V P术疗效好、并发症     

Blood-aqueous barrier after phacoemulsification with posterior chamber lens implantation; foldable acrylate lens vs PMMA lens-- a clinical study on 46 eyes

BACKGROUND: Cataract surgery leads to a more or less pronounced postoperative inflammation due to breakdown of the blood-aqueous barrier. This alteration of the blood-aqueous barrier can be reduced by minimally invasive surgery. The purpose of this study was to quantify the early course of the postoperative alteration of the blood-aqueous barrier following phacoemulsification with implantation of conventional PMMA posterior chamber lens (IOL) in comparison with foldable acrylic lens implantation. PATIENTS AND METHODS: Forty-six eyes of 46 patients (age 63 +/- 8.8 years) without preexisting deficiences of the blood-aqueous-barrier or previous intraocular surgeries were divided into two groups: group 1 (24 patients): phacoemulsification with one-piece-PMMA-IOL implantation (6.5 mm corneoscleral tunnel incision); group 2 (22 patients): phacoemulsification with foldable acrylic-IOL implantation (3.5 mm incision, 15 patients with corneoscleral tunnel and 7 patients with clear cornea incision). All surgical procedures were performed by one surgeon. The postoperative treatment was standardized. Alteration of the blood-aqueous barrier was quantified by the laser flare-cell meter (Kowa, FC-1000) preoperatively and on the first and the second day after surgery. RESULTS: Preoperative aqueous flare values (photon counts/ms) were comparable in both groups (6.7 +/- 2.7 versus 5.6 +/- 2.7 respectively, p = 0.1). On day 1, aqueous flare in group 1 (9.7 +/- 2.9) was not statistically significantly higher than in group 2 (9.2 +/- 2.2, p = 0.2) and remained relatively constant on day 2 after surgery (9.3 +/- 3.3), whereas the aqueous flare values in group 2 decreased statistically significant (6.7 +/- 2.3, p = 0.01). Postoperatively, there was no statistically significant difference of aqueous flare values between eyes with corneoscleral tunnel incision and eyes with clear corneal incision (p = 0.7) in group 2. CONCLUSIONS: Our study shows that phacoemulsification with foldable IOL implantation leads to a mild and short-lasting alteration of the blood-aqueous barrier. Thus, implantation of foldable IOL may be useful in eyes especially with preexisting alteration of the blood-aqueous-barrier.