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International Ophthalmology

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01-12-2024 | Laser | Original Paper

Anterior chamber flare and choroidal vascular index as inflammatory markers after uncomplicated phacoemulsification surgery

Authors: Gülay Yalçınkaya Çakır, Çiğdem Altan, İhsan Çakır

Published in: International Ophthalmology | Issue 1/2024

Abstract

Purpose

To determine the effect of phacoemulsification surgery, which is one of the types of cataract surgery by using ultrasonic power to break up the crystalline lens and clean it with vacuum, on anterior chamber flare (ACF) and choroidal vascular index (CVI).

Methods

For this cross-sectional study, patients were included if they had cataract with nucleus hardness grade 2 or 3, no systemic inflammatory disease, and not use of anti-inflammatory drugs/prostaglandins preoperatively. ACF using a laser flare meter and CVI in patients underwent uncomplicated phacoemulsification was recorded preoperatively, on the postoperative 1st day, 1st week, and 1st month.

Results

Fifty-six eyes were included. ACF was 9.00 ± 2.90 ph/ms preoperatively. Although ACF increased significantly on postoperative day-1 (39.38 ± 23.31ph/ms) and decreased gradually until the 1st month (14.03 ± 6.03ph/ms) after the operation, it was still significantly higher at the 1st month (p < 0.001). Macular and peripapillary CVI increased significantly on postoperative day-1 (0.64 ± 0.03/0.63 ± 0.05) and week-1 (0.64 ± 0.04/0.62 ± 0.04) (p = 0.01, p < 0.001); the postoperative 1st month was similar to the preoperative one (0.59 ± 0.06/0.58 ± 0.06). The relationship between the change in ACF and the change in CVI was not significant.

Conclusion

Phacoemulsification causes raises in ACF and CVI due to increased intraocular inflammation. The fact that ACF was significantly higher in postoperative month-1 and CVI returned to its preoperative value suggests that the effect of uncomplicated phacoemulsification surgery on the increase in inflammation in the anterior segment lasts longer than in the posterior segment. These results suggest that ACF and CVI follow-up may be clinically important in the follow-up of postoperative inflammation.

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Organization, WH (2007) Global initiative for the elimination of avoidable blindness: action plan 2006–2011.

Chen H, Wu Z, Chen Y, He M, Wang J (2018) Short-term changes of choroidal vascular structures after phacoemulsification surgery. BMC Ophthalmol 18:1–7CrossRef

De Maria M, Coassin M, Mastrofilippo V, Cimino L, Iannetta D, Fontana L (2020) Persistence of inflammation after uncomplicated cataract surgery: a 6-month laser flare photometry analysis. Adv Ther 37:3223–3233CrossRefPubMed

Ikegami Y, Takahashi M, Amino K (2020) Evaluation of choroidal thickness, macular thickness, and aqueous flare after cataract surgery in patients with and without diabetes: a prospective randomized study. BMC Ophthalmol 20:1–7CrossRef

Kahloun R, Attia S, Ksiaa I, Kacem I, Bouanene I, Zaouali S, Jelliti B, Khairallah M (2016) Anterior chamber aqueous flare, pseudoexfoliation syndrome, and glaucoma. Int Ophthalmol 36:671–674CrossRefPubMed

Buyuk K, Ozkagnici A (2012) Effectiveness of topical corticosteroid on anterior chamber flare reaction after phacoemulsification surgery/Fakoemulsifikasyon cerrahisi sonrasi on kamara flare reaksiyonu uzerine topikal kortikosteroid etkinligi. Turk J Ophthalmol 42:120–125CrossRef

Tugal-Tutkun I, Herbort CP (2010) Laser flare photometry: a noninvasive, objective, and quantitative method to measure intraocular inflammation. Int Ophthalmol 30:453–464CrossRefPubMed

Cheong KX, Tan CS (2015) Long-term increase in subfoveal choroidal thickness after surgery for senile cataracts. Am J Ophthalmol 3:608–609CrossRef

Ohsugi H, Ikuno Y, Ohara Z, Imamura H, Nakakura S, Matsuba S, Kato Y, Tabuchi H (2014) Changes in choroidal thickness after cataract surgery. J Cataract Refract Surg 40:184–191CrossRefPubMed

10.

Agrawal R, Chhablani J, Tan KA, Shah S, Sarvaiya C, Banker A (2016) Choroidal vascularity index in central serous chorioretinopathy. Retina 36:1646–1651CrossRefPubMed

11.

Yao H, Gao S, Liu X, Zhou Y, Cheng Y, Shen X (2020) Choroidal structural changes assessed with swept-source optical coherence tomography after cataract surgery in eyes with diabetic retinopathy. J Ophthalmol 2020:1–9

12.

Yip VCH, Laude A, Tan KA, Ding J, Wong E, Agrawal R (2019) A longitudinal study of choroidal changes following cataract surgery in patients with diabetes. Diab Vasc Dis Res 16:369–377CrossRefPubMed

13.

Chylack LT, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, Friend J, McCarthy D, Wu SY (1993) The lens opacities classification system III. Arch Ophthalmol 111:831–836CrossRefPubMed

14.

Ladas JG, Wheeler NC, Morhun PJ, Rimmer SO, Holland GN (2005) Laser flare-cell photometry: methodology and clinical applications. Surv Ophthalmol 50:27–47CrossRefPubMed

15.

De Maria M, Coassin M, Iannetta D, Fontana L (2021) Laser flare and cell photometry to measure inflammation after cataract surgery: a tool to predict the risk of cystoid macular edema. Int Ophthalmol 41:2293–2300CrossRefPubMed

16.

Abell RG, Allen PL, Vote BJ (2013) Anterior chamber flare after femtosecond laser–assisted cataract surgery. J Cataract Refract Surg 39:1321–1326CrossRefPubMed

17.

Siriwardena D, Kotecha A, Minassian D, Dart J, Khaw P (2000) Anterior chamber flare after trabeculectomy and after phacoemulsification. Br J Ophthalmol 84:1056–1057CrossRefPubMedPubMedCentral

18.

Cakir I, Altan C, Yalcinkaya G, Ozveren M, Kabakci AK, Taskapili M (2022) Evaluation of post phacoemulsification inflammation in eyes with and without pseudoexfoliation syndrome according to phaco parameters via laser flare photometry. Photodiagn Photodyn Ther 38:102805CrossRef

19.

Schumacher S, Nguyen NX, Küchle M, Naumann GO (1999) Quantification of aqueous flare after phacoemulsification with intraocular lens implantation in eyes with pseudoexfoliation syndrome. Arch Ophthalmol 117:733–735CrossRefPubMed

20.

Liu YC, Setiawan M, Ang M, Yam GHF, Mehta JS (2019) Changes in aqueous oxidative stress, prostaglandins, and cytokines: comparisons of low-energy femtosecond laser–assisted cataract surgery versus conventional phacoemulsification. J Cataract Refract Surg 45:196–203CrossRefPubMed

21.

Karslioglu MZ, Kesim C, Yucel O, Yildiz Tas A, Torun S, Altan C, Sahin A (2021) Choroidal vascularity index in pseudoexfoliative glaucoma. Int Ophthalmol 41:4197–4208CrossRefPubMed

22.

Ozcelik Kose A, Imamoglu S, Balci S, Yenerel NM (2022) Comparison of choroidal vascularity index in patients with pseudoexfoliation glaucoma, pseudoexfoliation syndrome, and healthy controls. Curr Eye Res 47:154–160CrossRefPubMed

Title: Anterior chamber flare and choroidal vascular index as inflammatory markers after uncomplicated phacoemulsification surgery
Authors: Gülay Yalçınkaya Çakır
Çiğdem Altan
İhsan Çakır
Publication date: 01-12-2024
Publisher: Springer Netherlands
Keywords: Laser
Cataract
Published in: International Ophthalmology / Issue 1/2024
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-024-02959-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anterior chamber flare and choroidal vascular index as inflammatory markers after uncomplicated phacoemulsification surgery

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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