Fibrinous uveitis and intraocular lens implantation. Surface modification of polymethylmethacrylate during extracapsular cataract surgery.

Abstract

The causes of fibrinous uveitis after cataract surgery are unclear, but surface modification of polymethylmethacrylate (PMMA) is known to influence post-operative inflammation. One hundred twenty-five patients were entered into a prospective investigation designed to assess the effect of intraoperative surface modification of PMMA, by coating with a 2% hydroxypropyl methylcellulose solution, on the incidence of fibrinous uveitis after extracapsular cataract surgery and lens implantation. Of the 125 patients entered into this prospective study, 90 received pretreatment with a 1% indomethacin solution. Fibrinous uveitis developed in 18(33%) of 54 eyes with dry lens implantation and in 1 (3%) of 36 eyes with coated lens implantation (P less than 0.005). Thirty-five eyes were not pretreated with indomethacin, and fibrin formation occurred in 6 (30%) of 20 dry implanted eyes and in 0 of 15 eyes with coated lens implantation (S = 0.02). Intraoperative modification of the PMMA surface of an intraocular lens during implantation significantly reduces the severity of postoperative inflammation, as manifest by the incidence of fibrinous uveitis.