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Luca Schwarzenbacher, Daniel Schartmueller, Christina Leydolt, Rupert Menapace; Intraindividual comparison of proinflammatory cytokines (IL-1β, IL-6) and total-prostaglandin (PG) following Femtosecond Laser-assisted Cataract Surgery using a Low-energy, High-frequency Femtosecond Laser-Device compared to Manual Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4789.
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© ARVO (1962-2015); The Authors (2016-present)
Controversy exists regarding topical NSAID pretreatment before Femtosecond Laser-assisted Cataract Surgery (LCS). We performed a prospective, intraindividual, randomized study to learn about IL and PG release in LCS with a low-energy, high-frequency laser device.
80 eyes of 40 patients with age-related cataract were included in this prospective study. Patients’ eyes were randomized into two groups, each eye receiving conventional phacoemulsification and LCS on the contralateral eye subsequently. Aqueous humor (AH) was extracted initially before manual cataract surgery in group I and exactly 5 minutes after laser pretreatment in group II.All cumulative samples of AH were analyzed in the same laboratory with Enzyme-linked Immunosorbent Assay (ELISA) Kits for IL-1β; IL-6 and PG. Wilcoxon-Signed-Rank test was applied to compare the groups. p<0.05 was considered significant.
Samples (n=80) from 28 (70%) female and 12 (30%) male patients were included. Average age at time of surgery was 71±9 [42;86] years. Lens density (LOCSIII) between groups (LCS vs. manual) was shown to be comparable (McNemar’s test: χ2 (4) = 6.00, p=0.199).Median PG values in the LCS group were 20.15 pg/ml [0.0;225.9], 0.0 pg/ml [0.0;18.95] for IL-1β and 0.45 pg/ml [0.05;2.60] for IL-6. Median values in the manual control group were 0.0 pg/ml [0.0;48.37], 0.48 pg/ml [0.09;4.06] and 0.0 pg/ml [0.0;2.10], respectively. A statistically significant difference could be shown for the comparison of PG (p=0.030), whereas no differences were found for IL-1β and IL-6 (p=0.359; p=0.787).There was no significant correlation in lens density and inflammatory parameters in any coincidence (p’s ≥ 0.484). No correlation was found for applied suction time to the inflammatory parameters assessed in the LCS group (n=40; p=0.918; p=0.419; p=0.427).
Laser treatment with a low-energy, high-frequency femtosecond laser-device results in a statistically significant increase of PG in AH, whereas no statistically significant increase was found for IL-1β and IL-6. However, longer suction time doesn’t seem to trigger PG and cytokine release in AH. Further assessment using no topical NSAIDs preoperatively should be evaluated in LCS to understand its effect on inflammatory stimuli.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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