Einfluss der Dauer der Phakoemulsifikation auf die postoperative Inflammation - eine retrospektive Studie

Andreas J. Kruger; Jörg Schauersberger; Claudette Abela-Formanek; Gebtraud Schild; Christian Kellner; Julia Kolodjaschna; Michael Amon

doi:10.1055/s-2001-14914

Klinische Monatsblätter für Augenheilkunde, Table of Contents

Klin Monbl Augenheilkd 2001; 218(4): 204-208
DOI: 10.1055/s-2001-14914

KLINISCHE STUDIE

Georg Thieme Verlag Stuttgart ·New York

Einfluss der Dauer der Phakoemulsifikation auf die postoperative Inflammation - eine retrospektive Studie[1]

Influence of phacotime on postoperative inflammation - a retrospective studyAndreas J. Kruger, Jörg Schauersberger, Claudette Abela-Formanek, Gebtraud Schild, Christian Kellner, Julia Kolodjaschna, Michael Amon

Universitätsklinik für Augenheilkunde und Optometrie, AKH Wien, Währinger Gürtel 18 - 20, 1090 Wien, Österreich
(Vorstand: O. Univ.-Prof. Dr. Heinz Freyler)

Abstract

Zusammenfassung

Hintergrund Die frühe postoperative Inflammation nach Kataraktchirurgie ist vorwiegend durch das Operationstrauma bedingt.

Patienten und Methoden Die Daten von 450 augengesunden Patienten, die sich einer Kleinschnitt-Routinekataraktchirurgie unterzogen, wurden retrospektiv analysiert. Die postoperative Inflammation wurde standardisiert am 1., 3., 7. und 28. Tag mit dem Laser-Flare-Cell-Meter Kowa FC-1000 gemessen. Alle Operationen wurden mit derselben Phakomaschine Orbit der Firma Oertli durchgeführt und die absolute Dauer der Phakoemulsifikation gemessen. Die teststatistische Auswertung erfolgte nach Klassierung der Daten mittels Student-t-Test.

Ergebnisse In der ersten postoperativen Woche zeigt sich ein statistisch signifikanter Unterschied zwischen den Gruppen mit kurzer Phakozeit (bis 39 Sekunden Dauer) und der Gruppe mit langer Phakozeit (über 80 Sekunden). Ein Monat postoperativ war dies nicht mehr nachweisbar.

Schlussfolgerungen Die Dauer der Phakoemulsifikation hat einen wesentlichen Einfluss auf die postoperative Inflammation. Operationstechniken und Operationsgeräte, die helfen die Phakozeiten zu verkürzen, sind auch in Hinblick auf die postoperative Inflammation vorzuziehen.

Background The early postoperative inflammation after cataract surgery is mainly caused by surgical trauma.

Patients and Methods 450 data-sheets of patients, who were operated for senile cataract with small-incision phacoemulsification and in-the-bag implantation of a foldable intraocular lens were retrospectively analysed. Postoperative inflammation was evaluated with the Laser Flare-Cell Meter Kowa FC-1000 on day 1, 3, 7 and 28. All the operations were done with the same phacomachine model Orbit Oertli. The absolute phacotime was measured, the data classified in steps of 20 seconds. Statistical analysis was made with the student's t-test.

Results In the first postoperative week there is a statistical significant difference in the flare-values between the groups with short phacotime (up to 39 seconds) and the group with long phacotimes (over 80 seconds). One month after operation this significance was absent.

Conclusions The early postoperative inflammation is influenced by the duration of phacoemulsification. Surgical techniques and phacomachines that may reduce phacotime are helpful with respect to early postoperative inflammation.

Schlüsselwörter

Katarakt - Laser-Flare-Cell-Meter - Blut-Kammerwasser-Schranke - Inflammation - Phakoemulsifikation

Key words

Cataract - Laser-Flare-Cell-Meter - blood-aqueous-barrier - inflammation - phacoemulsification

Full Text

References

Literatur

01 ¹ Manuskript erstmalig eingereicht am 19. 10. 00 und in der vorliegenden Form angenommen am 1. 12. 00.

01 Abela-Formanek C, Amon M, Schauersberger J, Schild G, Kruger A. Postoperative inflammatory response to phacoemulsification and implantation of 2 types of foldable intraocular lenses in pseudoexfoliation syndrome. Klin Monatsbl Augenheilkd. 2000; 217 10-14.
02 Alio J L, Sayans J A, Chipont E. Flare-cell meter measurement of inflammation after uneventful cataract surgery with intraocular lens implantation. J Cataract Refract Surg. 1997; 23 935-939.
03 Alio J L, Sayans J A, Chipont E. Laser flare-cell measurement of inflammation after uneventful extracapsular cataract extraction and intraocular lens implantation. J Cataract Refract Surg. 1996; 22 Suppl 1 775-779.
04 Chee S P, Ti S E, Sivakumar M, Tan D T. Postoperative inflammation: extracapsular cataract extraction versus phacoemulsification. J Cataract Refract Surg. 1999; 25 1280-1285.
05 DeBry P, Olson R J, Crandall A S. Comparison of energy required for phaco-chop and divide and conquer phacoemulsification. J Cataract Refract Surg. 1998; 24 689-692.
06 Dowler J G, Hykin P G, Hamilton A M. Phacoemulsification versus extracapsular cataract extraction in patients with diabetes. Ophthalmology. 2000; 107 457-462.
07 el-Harazi S M, Feldman R, Chuang A Z, Ruiz R S, Villanueva G. Reproducibility of the laser flare meter and laser cell counter in assessing anterior chamber inflammation following cataract surgery. Ophthalmic Surg Lasers. 1998; 29 380-384.
08 el-Maghraby A, Marzouki A, Matheen T M, Souchek J, Van-der-Karr M. Reproducibility and validity of laser flare/cell meter measurements of intraocular inflammation. J Cataract Refract Surg. 1993; 19 52-55.
09 Gills J P, Sanders D R. Use of small incisions to control induced astigmatism and inflammation following cataract surgery. J Cataract Refract Surg. 1991; 17 Suppl 740-744.
10 Kruger A, Schauersberger J, Findl O, Petternel V, Svolba G, Amon M. Postoperative inflammation after clear corneal and sclerocorneal incisions. J Cataract Refract Surg. 1999; 24 524-528.
11 Laurell C G, Zetterstrom C, Philipson B, Syren Nordqvist S. Randomized study of the blood-aqueous barrier reaction after phacoemulsification and extracapsular cataract extraction. Acta Ophthalmol Scand. 1998; 76 573-578.
12 Obstbaum S A. Biologic relationship between poly(methyl methacrylate) intraocular lenses and uveal tissue. J Cataract Refract Surg. 1992; 18 219-231.
13 Petternel V, Findl O, Kruger A, Schauersberger J, Amon M. Effect of tropicamide on aqueous flare before and after cataract surgery. J Cataract Refract Surg. 2000; 26 382-385.
14 Schauersberger J, Kruger A, Abela C, Muellner-Eidenbock A, Petternel V, Svolba G, Amon M. Course of postoperative inflammation after implantation of 4 types of foldable intraocular lenses. J Cataract Refract Surg. 1999; 25 1116-1120.
15 Schauersberger J, Kruger A, Muellner-Eidenbock A, Petternel V, Abela C, Svolba G, Amon M. Long-term disorders of the blood-aqueous barrier after small-incision cataract surgery. Eye. 2000; 14 61-63.
16 Ursell P G, Spalton D, Whitcup S M, Nussenblatt R B. Cystoid macular edema after phacoemulsification: relationship to blood-aqueous barrier damage and visual acuity. J Cataract Refract Surg. 1999; 25 1492-1497.
17 Walkow T, Anders N, Klebe S. Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters. J Cataract Refract Surg. 2000; 26 727-732.