Heparin infusion in pediatric cataract surgery may not reduce postop inflammation

Intraocular infusion of low-molecular-weight heparin did not significantly reduce early postoperative inflammation in children undergoing bilateral cataract extraction and IOL implantation, a study found.

“Perhaps the advent of newer techniques, cutting-edge technology, and superior IOL materials may have reduced the occurrence of postoperative inflammation in these young eyes without the need for any adjunctive agents,” the study authors said.

The prospective, randomized, double-masked trial included 40 eyes of 20 children who were randomized to undergo cataract surgery and IOL implantation with or without enoxaparin, a low-molecular-weight heparin, in the intraocular infusion fluid. The first eye was randomized to one treatment and the second eye underwent the other treatment.

Mean patient age was 40.89 months in the enoxaparin group and 40.8 months in the control group.

Patients were evaluated in the first week postoperatively and at 1 and 3 months. Primary outcome measures were anterior chamber flare and cells, cell deposits on IOLs, and posterior synechiae.

Study results showed that at 1 week after surgery, no eyes had greater than grade 2 flare or cells. Significantly more eyes in the control group had grade 2 cells than those in the enoxaparin group (P = .009).

At 1 week postop, eyes in the enoxaparin group had more than 10 small cell deposits, while eyes in the control group had no deposits (P = .005).

At 1 month, large cell deposits were first identified in 40% of eyes in the enoxaparin group and 55% of eyes in the control group; the between-group difference was statistically insignificant. Large cell deposits were seen in 60% of eyes in both groups at 3 months, the authors said.

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Source:

Am J Ophthalmol. 2012;154(2):252-258.