[The anti-inflammatory effect of heparin-containing infusion solutions during phacoemulsification].

UNLABELLED

The use of heparin prevented postoperative intraocular fibrin-clot formation in the rabbit after vitrectomy and cyclocryotherapy. A low rate of postoperative intraocular inflammation was observed in our patients receiving phacoemulsification with heparin infusion solution (slit-lamp examination). To verify this effect a randomized, prospective study was performed using laser-flare cell photometry (LFCP) for measuring protein concentration in the anterior chamber.

PATIENTS AND METHODS

Seventy-two patients (49-87 years of age) were randomly assigned to one of the following two surgical groups (temporal clear corneal tunnel incision with phacoemulsification): group A: foldable silicone IOL (Chiron C10), no stitch (3.5 mm incision); group B: PMMA-IOL (Pharmacia 809P) with one radial suture (5 mm incision). Fifty percent of the patients in each group received, in addition to the regular phaco infusion, 1 ml of heparin sodium (-H = without heparin; +H = with heparin). Aqueous flare was measured preoperatively as well as on days 1 and 3 following phaco + IOL with LFCP (Modell FC-1000; Kowa Company).

RESULTS

In group A1 (-H) or B1 (-H) the mean flare values (in photon counts/ms) increased from a preoperative value of 7.0 +/- 1.7 (mean +/- SD) or 6.9 +/- 1.2 to 20.2 +/- 3.1 or 20.1 +/- 3.0 on the 1st postoperative day, whereas they decreased again to 13.8 +/- 2.9 or 14.8 +/- 3.1 on day 3 following surgery. In groups with heparin sodium A2(+H) and B2(+H) the flare values only increased from 7.2 +/- 1.3 or 7.1 +/- 1.3 to 12.9 +/- 4.0 or 13.8 +/- 3.8 on day 1, and decreased to 8.0 +/- 2.8 or 8.8 +/- 3.0 on the 3rd postoperative day. The mean postoperative flare values were significantly lower in the groups with additional heparin (p < 0.01).

CONCLUSIONS

Heparin sodium in the infusion solution during small incision cataract surgery showed an antiinflammatory effect in the early postoperative period. There was no significant difference between the two IOL materials.