Effects of postoperative inflammation on visual and refractive recovery after cataract surgery: role of subconjunctival dexamethasone.

PURPOSE: To evaluate the influence of postoperative inflammation on visual and refractive recovery after cataract surgery and the effect of subconjunctival dexamethasone injection (Dex) at the end of surgery.

METHODS

This retrospective comparative cohort study included 112 eyes of 112 patients undergoing phacoemulsification with the same intraocular lens (IOL) by a single surgeon; 57 eyes received Dex and 55 did not, and the groups were compared. Correlations were analyzed between aqueous flare (Flare) change from postoperative day 1 to week 1 (Flare1d-1w) and visual and refractive parameter changes from day 1 to month 1 (1d-1m). Multivariate regression was performed to evaluate factors associated with postoperative visual and refractive outcomes.

RESULTS

Flare1d-1w correlated with best-corrected visual acuity (BCVA)1d-1m (p < 0.0001, r = 0.63), central corneal thickness (CCT)1d-1m (p < 0.0001, r = 0.83), and anterior chamber depth (ACD)1d-1m (p < 0.0001, r = -0.53). In multivariate analysis, CCT1d-1m was significantly associated with BCVA1d-1m, whereas ACD1d-1m was retained in the model for refractive prediction error at 1m, but did not reach statistical significance. Dex(+) eyes showed smaller Flare1d (p < 0.0001), Flare1w (p = 0.0037), and Flare1d-1w (p = 0.0287), and earlier recovery of vision and refraction than Dex(-). Dex(-) eyes had deeper ACD1m.

CONCLUSIONS

Postoperative inflammation was associated with delayed visual and refractive recovery. Dex was associated with less postoperative inflammation and earlier recovery within the first month.