COMPARISON OF THE BREAKDOWN OF THE BLOOD- AQUEOUS BARRIER AFTER EXTRACAPSULAR CATARACTEXTRACTION IN DIABETIC AND NONDIABETIC PATIENTS
A.B. Arnavaz, G.E. Lang, B. Lüttke, H.C. Gäckle, G.K. Lang
Purpose. The impact of phacoemulsification (ECCE) and implantation of a posterior chamber lens (PCL) on aqueous protein concentration was studied prospectively in diabetic and age-matched nondiabetic patients.
Methods. Protein concentration was measured with a Laser Flare Meter Kowa FM 500 in 33 consecutive patients with type 2 diabetes mellitus and in 51 nondiabetic patients (control group). Measurement was performed one day before, one day and 4 weeks affer cataract surgery and correlated to age, sex, blood glucose level, visual acuity, presence of diabetic retinopathy and cystoid macular edema assessed by fluorescein angiography. The data were statistically analyzed by Kruskal-Wallis-, Wilcoxon-, Friedman-, and Mann-Whitney U test.
Results. Mean age was 69 years in the patients and 71 years in the control group. Thirtyseven probands were male, 46 female. In 15 of 33 patients diabetic retinopathy was present. Nine of 15 patients had cystoid macular edema. There was no significant difference (p=0.5) of flare values between the diabetic and the control group for all three measurements. Mean flare values however correlated significantly with higher blood glucose level (p=0.0001), age (p=0.02), and presence of cystoid macular edema (p=0.006) in the patient group. For the other parameters no correlation was found.
Conclusions. No significant difference of postoperative aqueous protein concentration was found between the diabetic patients and the control group after ECCE with PCL. Within the diabetic group however there was a correlation between blood glucose level, higher age, presence of cystoid macular edema and increased aqueous protein concentration.
Supported by Landesforschungsschwerpunkt "Diabetes mellitus" Baden- Württemberg
University of Ulm, Department of Ophthalmology; Prittwitzstrasse 43, D-89075 Ulm