Quantification of aqueous flare after phacoemulsification with intraocular lens implantation in eyes with pseudoexfoliation syndrome

Background: Impairment of the blood-aqueous barrier is a frequent finding in eyes with pseudoexfoliation syndrome (PEX). Objective: To perform noninvasive quantification of aqueous flare using the laser flare-cell meter to analyze blood-aqueous barrier breakdown following phacoemulsification with intraocular lens implantation in eyes with and without PEX. Methods: After other conditions that might account for impairment of the blood-aqueous barrier were excluded, 11 eyes with PEX and 11 eyes with senile cataract without PEX were included in the study. Aqueous flare was quantitatively determined using a laser flare-cell meter preoperatively as well as 1, 3, and 5 days postoperatively. Phacoemulsification with posterior chamber intraocular lens implantation was performed by one surgeon. Results: On the first postoperative day, flare values (calculated as mean +/- SD photon counts per millisecond) in eyes with PEX were higher (42.2 +/- 21.3) than in eyes without PEX (30.6 +/- 15.1) (P > .05). On days 3 and 5, postoperative flare values decreased slowly in eyes with PEX (23.9 +/- 7.4 and 21.2 +/- 5.7 photon counts per millisecond, respectively) and were significantly higher than in eyes without PEX (14.8 +/-: 5.4 and 10.5 +/- 1.4 photon counts per millisecond, respectively) (P < .05). Conclusions: Breakdown of the blood-aqueous barrier is significantly more extensive in eyes with PEX and may be an important risk factor for early postoperative complications. The altered response to surgery should be considered in eyes with PEX.