Disruption of the blood-aqueous barrier by residual lens epithelial cells after intraocular lens implantation.

We performed a clinical study to confirm whether and how residual lens epithelial cells (LECs) participate in postoperative pseudophakic inflammation, including fibrin reaction. Twenty-six eyes of 13 patients with bilateral cataracts were treated by phacoemulsification and posterior chamber intraocular lens (PC-IOL) implantation. In the eye from which LECs had not been removed, the aqueous flare was measured with a laser flare-cell meter. Flare decreased from an initial peak, increasing again to form a flare spike when LECs came into contact with the PC-IOL and began to undergo fibrous proliferation at 6 to 14 days after surgery. The spike was evidence that the blood-aqueous barrier had been disrupted again. Fibrin reaction developed in two eyes. In the other eye of each pair, from which LECs had been removed by ultrasound aspiration, neither a flare spike nor fibrous proliferation was noted. We conclude that residual LECs break down the blood-aqueous barrier as they proliferate and are involved in postoperative pseudophakic inflammation.