Brief inflammatory profile after femtosecond laser-assisted pretreatment in nuclear cataract surgery

Abstract

Purpose : Femtosecond laser-assisted cataract surgery (FLACS) is an FDA-approved treatment with increasing popularity. So far, there are no studies assessing the inflammatory response to FLACS corneal incision, anterior capsulorhexis, and nuclear fragmentation before phacoemulsification in patients exclusively diagnosed with nuclear cataracts. Here, we measured key inflammatory markers in the aqueous humor of patients exposed to femtosecond laser pretreatment.

Methods : We performed a cross-sectional study of 67 patients diagnosed with nuclear cataract (LOCS III NO3) undergoing surgery. Of those, 34 were exposed to femtosecond laser pretreatment. At the beginning of the surgery, we collected aqueous humor samples under sterile conditions through a side-port incision. Samples were collected 8 minutes after laser treatment. We measured PgE2 by competitive ELISA, IL-1 β, and IL-6 through cytometric bead arrays. We performed bivariate and stratified analysis in SAS v.9.4.

Results : There was a statistically significant increase of PgE2 (Adjusted β 3.24, SE 1.57, p=0.0001) and IL-6 (Adjusted β 3.40, SE 0.37, p=0.0001) in the FLACS group compared to manually performed incisions (PgE2 mean 2.6 and IL-6 mean 2.7). There was no significant difference in IL-1 β levels between groups.

Conclusions : FLACS-exposed cases have a significant increase in IL-6 and PgE2 during the first steps of the surgical approach. The clinical implications of these elevations warrant future study.

This is a 2020 ARVO Annual Meeting abstract.

 

IL-6 and PgE2 stratified by treatment group, comparing FLACS measurements with manually performed incisions.