Abstract :
Purpose: To evaluate the influence of heparinized irrigation solution on postoperative inflammation on
anterior chamber cellular reaction (ACR) after cataract surgery in diabetics.
Materials and Methods: 120 patients of 164 patients selected for the study who completed 2 months
follow up were included in this study. Patients with controlled blood sugar levels with cataract attending
R.L. Jalappa Hospital OPD (Outpatient department) were selected. Consecutive patients were segregated
into 2 groups. All patients underwent manual small incision cataract surgery (MSICS) under peribulbar
anaesthesia performed by a single surgeon. Superior 6mm sclerocorneal tunnel was made and cataract was
extracted and rigid PMMA (Polymethyl metha acrylate) lens was implanted in the bag. The remaining
viscoelastic substance was replaced by balanced salt solution (BSS).
In group 1, 5000 IU Low molecular weight heparin (LMWH) was added to balanced salt solution of 500
ml and hence the final concentration was 10 IU/ml of BSS. In group 2 heparin was not added to BSS.
Post operative anterior chamber (AC)reaction were noted on first postoperative day, after 1 week, 1 month
and 2 months. Intraoperative hyphaema, postoperative shallow AC and hyphaema were documented. The
AC reaction was noted by (Standard Uvea Nomenclature) SUN classification system. It is a prospective
randomized control trial. Statistical analysis was done by Chi-square test.
Results: Anterior chamber reaction was statistically significant between the two groups at Day 1 and Day 7
postoperatively with p value being < 0>
postoperative months with p value being statistically in significant.
Postoperative complications such as Cystoid macular oedema (CME) was seen in 4 patients in group 2 and
1 patient in group 1. Pigments on IOL was seen in 14 pts and 3 pts of group 1 and 2 respectively.
Conclusion: Addition of heparin to irrigating solution showed statistically significant lesser AC reaction
in Group 1 than Group 2 at first and seventh postoperative day. There was no difference in the anterior
chamber reaction in Group 1 and Group 2 at the end of postoperative 1 and 2 months.
Keyword :
Cataract, Heparin, Diabetes.