Abstract
Abstract: :
Purpose: To determine the effect of intraocular surgery on human aqueous and serum cytokines. To determine if ketamine has an effect on ocular cytokine release. Methods:Patients undergoing cataract surgery under general and local anaesthesia were randomised to one of three groups, those having general anaesthetic with (group 1) and without ketamine (group 2), and those having local anaesthetic without the use of ketamine (group 3). Ketamine (1mg/kg) was given intravenously as part of general anaesthetic procedure to the patients in group 1 before the start of cataract surgery. Paired aqueous and serum samples were taken before the start of surgery and before the administration of ketamine in group 1, and then 18 hours post–operatively in all three groups. Levels of cytokines – interleukin (IL) IL–1α, IL–1ß, IL–2, IL–4, IL–6, IL–8, IL–10, vascular endothelial growth factor (VEGF), tumour necrosis factor– α (TNF–α), interferon– γ (IFN– γ), epidermal growth factor (EGF) and monocyte chemotactic protein–1 (MCP–1) – were determined using multi–analytic biochip array technology. A clinical assessment of the level of ocular inflammation was made pre–operatively and at 18hours post–operatively. Results:34 patients completed the study. Preliminary results show that at 18 hours post cataract surgery, there were several fold increases in aqueous levels of IL–6, IL–8, TNF–α and MCP1, but little change in IL–1, IL–2, IL–4, IL–10 and EGF. There was no appreciable change in serum levels of the above cytokines. There was no significant difference in clinical ocular inflammation between the groups. Conclusions: There is a selective effect of surgery on aqueous cytokines at 18 hours post–surgery. It is unclear at present whether ketamine has an effect on intraocular cytokine release.
Keywords: cytokines/chemokines • aqueous • cataract