Vitreous cytokine profile after phaco-emulsification and posterior segment chamber lens placement
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The purpose of this study was to quantify the effects of phacoemulsification and posterior segment chamber lens placement on vitreous inflammatory and neovascular growth factors. More specifically, the effect of immediately preceding cataract surgery was compared to a history of cataract surgery. This study involved a retrospective review and analysis of vitreous samples from a total of twenty seven patients separated into three groups. Group 1, seven patients who underwent a pars plana vitrectomy with macular surgery, group 2, fourteen patients who underwent a combined cataracts and pars plana vitrectomy procedure and group 3, six patients with a history of cataract surgery who underwent a pars plana vitrectomy. The twenty seven patients were picked from a pool of 100 patients who all received pars plana vitrectomy at Beth Israel Deaconess Medical Center with surgeon Dr. Jorge Arroyo. Exclusion factors included active ocular pathologies such as vitreous hemorrhage and retinal detachment. Undiluted vitreous samples from each group were taken before beginning the pars plana vitrectomy. The vitreous samples were analyzed for concentrations of fourteen specific vitreous cytokines and neovascular growth factors including but not limited to TNF Alpha; and SCD40L. These fourteen cytokines and growth factors were chosen through a literature review on the post-surgery ocular inflammatory response. Statistical analysis was done on the average means of the cytokine levels for each group using SPSS 20 for windows. A comparison of means analysis found no significant difference in the means of the fourteen cytokines for group 1 and group 2. A second comparison of means with a pooled control group of both group 1 and group 2 patients versus group 3 was also run. In this analysis, only SCD40L or soluble CD40 ligand was shown to have a significant difference between groups. SCD40L levels were significantly higher (significance level of .038) in group 3, the history of cataract group with a mean of (9.50±4.76) than in the control group with a mean of (5.50±3.35). The findings of this study indicate that the protein SCD40L may play an important role in mediating the inflammatory response seen post cataract surgery and may be useful as a target for novel therapies against the inflammatory response.