Abstract
Purpose :
To study the immunologic variability of Tenon capsule in smokers, past-smokers and non-smokers.
Methods :
In this study with a cross sectional descriptive design, 30 eyes of patients with glaucoma who were candidates for Trabeculectomy + Mitomycin C (MMC) were divided into 3 groups based on their tobacco smoking habits - 10 active smoker patients, 10 non-smoker patients and 10 past-smoker patients. Patients with auto-immune conditions or previous conjunctival surgery or pathology were excluded. Patients were recruited among three different clinics by four different glaucoma specialists. Signature of informed consent was obtained prior to procedure, participants answered a questionnaire regarding past medical history, current medications, smoking history and exposure, and previous ocular interventions. A 2x2 mm histologic specimen of Tenon’s capsule was obtained during trabeculectomy procedure previous to the use of MMC in each of the participating patients. A qualitative histopathological study of fibrous connective tissue, presence of inflammatory cells and density of fibroblast was done using special staining and study under light high-magnification microscope.
Results :
22 patients have been enrolled so far in the study. 5 active smoker patients, 10 past-smoker patients and 7 non-smoker patients. Mean age for participants was 67± 10.66 years. A 68.2 % of the patients were males. Almost half of the patients in the smoking group referred smoking 10 or more cigarettes a day for a mean of 28.5± 22.6 years. In the past smokers group the mean of years since they quit smoking was 29.67 years range between 7 to 48 years. There was no significant difference between the number of medications used in each group. A higher rate of CD68+ cells and T cells were more abundant in tissue of smokers, followed by past-smoker and the lower rate present in non-smoker patients.
Conclusions :
Although more active smokers and non-smokers need to be enrolled in the study, histopathologic results could support the clinical observations that had suggested more inflammation and therefore could lead to early failure after trabeculectomy + MMC in smokers.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.