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Katsuhiko Maruyama, Yoshihiko Usui, Shunichiro Ueda, Takeshi Kezuka, Hiroshi Goto; Relationship between incidence of post-trabeculectomy posterior capsular cataract and aqueous humor levels of immune mediators. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5697.
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To investigate the relationship between the incidence of posterior capsular cataract after trabeculectomy and the levels of immune mediators in aqueous humor in patients with primary open-angle glaucoma (POAG).
Twenty-seven patients (32 eyes) with POAG undergoing trabeculectomy were enrolled in this cross-sectional study. Patients with a history of intraocular surgeries including laser treatment, or other ocular diseases except glaucoma at the time of trabeculectomy were excluded. Age was 53.1 +/- 7.1 (37-65) years [mean +/- standard deviation (range)]; spherical equivalent refraction was -7.26 +/- 3.40 (-20.00--2.50) diopter; preoperative intraocular pressure (IOP) was 16.1 +/- 2.9 (12-22) mmHg; and mean deviation (MD) determined by Humphrey Field Analyzer 30-2 program was -16.75 +/- 6.20 (-27.98- -2.97) decibel. Undiluted aqueous humor samples were collected at the start of trabeculectomy, and cytometric beads array kits were used to determine the concentrations of 28 immune mediators including interleukin (IL)-6, IL-8, vascular endothelium growth factor (VEGF), monokine induced by interferon gamma (Mig), interferon gamma inducible protein-10 (IP-10), and monocyte chemoattractant protein (MCP)-1. Spearman’s rank correlation test was used to analyze the correlation of aqueous humor concentration of each immune mediator with 6-month postoperative IOP, incidence of hypotony defined as IOP of 5 mmHg or below, and incidence of posterior capsular cataract examined by slit lamp biomicroscopy. P <0.05 was considered significant.
There was no significant correlation between aqueous humor concentration of each immune mediator and age, spherical equivalent refraction, preoperative IOP, or MD. The 6-month postoperative IOP was 8.0 +/- 3.3 (2-16) mmHg. Hypotony was detected in 16 eyes, and posterior capsular cataract also in 16 eyes. Although there was no significant correlation between aqueous humor concentration of each immune mediator and 6-month postoperative IOP or incidence of hypotony, a significant relationship between incidence of posterior capsular cataract and MCP-1 level was detected (r=0.44, p=0.01).
Our study suggests that elevated MCP-1 level in aqueous humor in patients with POAG undergoing trabeculectomy affects the incidence of postoperative posterior capsular cataract.
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