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Inflammation in cataract surgery

Cataract surgery induces rupture of the blood–ocular barrier. Topical corticosteroids or NSAIDs have been demonstrated to be effective in the management of postoperative inflammation after cataract surgery. Endophthalmitis, toxic anterior segment syndrome or retained intraocular lens material may be responsible for increased postoperative inflammation. The choice of a less traumatic phacoemulsification technique, small incision, adequate infusion solution and implantation in the bag, may reduce postoperative inflammation. In severe uveitis, adequate control of inflammation should be achieved for at least 3 months and surgery should be performed when intraocular inflammation is brought under control, using systemic corticosteroids or immunosuppressive therapy as needed. In the presence of decreased visual acuity postoperatively, cystoid macular edema should be ruled out clinically, by either optical coherence tomography or fluorescein angiography. The recent development of biopolymers as drug-delivery systems has shown their efficacy in the management of intraocular inflammation after cataract surgery.