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L. P. Chang, T. Wong, M. Ohbayashi, C. Bunce, S. Ono, P. T. Khaw; Investigation of the Mast Cell Profile in the Conjunctiva of Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):835.
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© ARVO (1962-2015); The Authors (2016-present)
Inflammation is a clinical risk factor for scarring after glaucoma filtration surgery. Mast cells have been implicated as important mediators of inflammation and tissue remodelling in allergic eye diseases such as VKC. This project was designed as an exploratory study to investigate the presence of mast cells in glaucoma patients undergoing glaucoma filtration surgery and their potential role in tissue remodelling after glaucoma surgery.
Conjunctival biopsies were obtained from glaucoma patients allocated to the following groups: glaucoma patients on medical treatment (group M), scarred glaucoma patients undergoing repeat glaucoma surgery (group S), uveitic glaucoma patients (group U). The control group (group C) were patients who were undergoing retinal detachment repair surgery for the first time who have never been medicated and with no previous history of allergic eye disease. Immunohistochemistry techniques were employed to stain for the presence of the intracellular mast cell enzyme tryptase.
The median mast cell tryptase-positive counts for all glaucoma groups (MSU) ranged from 0.102 - 0.113 cells/mm2 compared to 0.064 cells/mm2 for group C. This reached statistical significance when comparing group S to group C (p=0.0063) but did not reach statistical significance when comparing groups U or M to group C. The mast cell tryptase-positive counts did not significantly differ amongst the groups. When all glaucoma groups (MSU) were considered together there was a significant difference in the mast cell tryptase-positive count compared to controls group C (p=0.0112).
Mast cell numbers appear to be increased in medicated glaucoma patients, in glaucoma patients who have previously undergone surgery and in uveitic glaucoma patients although this only reached statistical significance in patients who were undergoing repeat filtration surgery (group S). Mast cell activity may contribute to the postoperative wound healing process and the increased risk of excessive conjunctival scarring after glaucoma filtration surgery. Further investigation needs to be performed to evaluate this potential role.
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