Disruption of the BloodAqueous 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 bloodaqueous 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.