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R. S. Chong, Y. Jiang, P. Boey, S. Yu, H. Htoon, T. Aung, P. Khaw, T. Wong; Tear Cytokine Profile in Medically Treated Glaucoma Patients Undergoing Trabeculectomy: Effect of MCP-1 on Early Post-Operative Outcome. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6125.
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To determine the tear cytokine profile from medicated glaucoma patients scheduled for trabeculectomy and to establish whether a specifically elevated cytokine level is related to early post-operative scarring.
Sixty-one patients treated with topical anti-glaucoma medications and 29 normal subjects with no prior topical treatment were recruited for the study. Schirmer strips were used to collect tear samples. Multiplex bead assay was used to quantify the presence of pro-inflammatory cytokines in the tears. The patients were followed up for six months after surgery to determine whether any post-operative intervention to maintain filtering bleb function was required. The level of cytokines in tear specimens from medicated glaucoma patients was the main outcome measure for the study. The need for post-operative bleb needling within six months was a secondary outcome measure.
Of the 17 cytokines assayed, only monocyte chemoattractant protein 1 (MCP-1) was significantly elevated in the medicated compared to the non-medicated eyes, (P<0.0004). At 6 months post-op, 18 of the 61 (30%) eyes required post-operative intervention. A much higher MCP-1 level was detected in these eyes compared to the remaining 43 that did not require intervention (P<0.0001). The duration of use of topical medication correlated with increasing levels of MCP-1 although the types of glaucoma medication and the number of bottles of medications did not have any significant relationship with MCP-1.
MCP-1 was found to be the predominant cytokine elevated in tears from topically medicated glaucoma eyes in an Asian population. Eyes with a propensity to scar in the early post-operative period have a significantly raised level of MCP-1.
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