| Summary: | Currently, phacoemulsification is the «gold» standard of cataract surgery. In a number of cases, post-surgical complications can develop in the form of an inflammatory reaction of varying degrees of severity. The purpose of the study was to develop a method for predicting the inflammatory reaction after phacoemulsification of cataract (PEC) by analyzing the clinical and immunological status of the patients.
Material and methods of investigation. The study included 318 patients (318 eyes) with age-related cataracts who underwent PEC. In a number of the patients (49 patients, 49 eyes) with age-related cataract 3 days before the surgery day and after the operation we performed a tear fluid intake. In the obtained samples of tears, the content of alpha2-macroglobulin (alpha2-MG), immunoglobulin G (IgG), albumin and lactoferrin was determined.
Results. All PEC operations were conducted according to the plan. In most operated patients, the post-surgical period proceeded smoothly, without an inflammatory response. Only in 19 patients (5.9 %) during the early post-surgical period we diagnosed an exudative reaction in the cavity of the eye. On the 1st day after the operation, the concentration of albumin in the tear fluid of the patients was sharply increased almost 2-fold, as well as the content of alpha2-macroglobulin.
Conclusion. A method for predicting the development of post-surgical intraocular inflammation has been elaborated:
1) We determine the concentration of alpha2-MG in the tear fluid of the eyes of the patients with cataract before surgery. If it is below 1.03 mg/l, then the probability of inflammation is low (because the sum of the remaining risk factors namely sex, age of the patients, the degree of cataract maturity, etc. does not exceed 20 scores), we perform the PEC operation in a planned manner.
2) If the sum of scores is higher than 20, the probability of inflammation is high. With a high risk of developing inflammation before surgery we perform intensive local and systemic anti-inflammatory therapy.
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