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A. Acera, M. Hernández, N. Nieto Rementeria, E. Vecino, J. Duran; Matrix Metalloproteinase-9 Levels in the Tears of Patients Before and After Conjunctivochalasis Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4299.
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Conjunctivochalasis is an isolated bilateral condition in which redundant conjunctival tissue overlies the lower eyelid margin or covers the lower punctum. Recent research has identified a possible inflammatory basis for the pathogenesis of conjunctivochalasis. Our purpose is to evaluate the inflammatory activity associated with this disease and its response to surgical treatment.
Twelve eyes of 8 patients with symptomatic conjunctivochalasis were included in this study. The principal subjective preoperative symptoms were irritation, lacrimation and foreign body sensation. Ocular surface inflammation was measured in terms of the concentration of matrix metalloproteinase 9 (MMP-9) in tears, by enzyme-linked immunoadsorbent assay (ELISA) and zymography. Tear analysis was performed before and one month after surgery. The surgical technique consisted in the excision of redundant tissue using organic glue (TisseelTM) for wound closure.Statistical analysis was carried out using the Mann-Whitney U test (level of significance: P<0.05).
MMP-9 levels in the tears of patients with conjunctivochalasis were significantly elevated before surgery (P=0.0016) compared with controls (23.61 ± 17.4 ng/ml). MMP-9 levels decreased 3.58 fold (P<0.001) following surgery (223.58 ± 74.64 ng/ml vs 62.41 ± 38.36 ng/ml, before and after surgery respectively).Zymographic analysis indicates that the MMP-9 is only activated in the tears of conjunctivochalasis patients.
Our results indicate that inflammation is likely to play a relevant role in the pathogenesis of conjunctivochalasis. Surgery decreases the inflammatory activity, leading to symptom improvement.
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