February 2019

RESIDENTS

Changes in aqueous oxidative stress, prostaglandin, and cytokines: Comparisons of low-energy femtosecond laser-assisted cataract surgery versus conventional phacoemulsification


by Yu-Chi Liu, MD, Melina Setiawan, BSc, Marcus Ang, FRCOph, Gary Hin Fai Yam, PhD, Jodhbir Mehta, FRCOph

J Cataract Refract Surg. 2019;45(2):196–203.

Purpose: To compare the aqueous oxidative stress, prostaglandin (PGE), and cytokine levels following low-energy femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification, and to evaluate the effect of non-steroidal anti-inflammatory (NSAID) on the aqueous profiles.
Setting: Singapore National Eye Center, Singapore.
Design: Randomized controlled trial.
Methods: Thirty-five patients were randomized to receive conventional phacoemulsification in one eye and FLACS (Ziemer) in the fellow eye. Another matched prospective cohort of 35 patients was included to receive FLACS with preoperative NSAID (FLACS-N). Aqueous humor was collected after laser or at the beginning of surgery (conventional phacoemulsification), and at the end of phacoemulsification. The levels of aqueous malondialdehyde (MDA), PGE2, cytokines/chemokines/growth factors were analyzed. Postoperative aqueous flare levels were evaluated.
Results: Compared to the conventional group, the FLACS group had a significantly higher PGE2 (P=0.01) and interleukin-1 receptor antagonist levels (P=0.04). Preoperative NSAID significantly reduced the PGE2 surge (P=0.002) and mean reduction in pupil diameter (P=0.02). The MDA concentrations before phacoemulsification were 0.24±0.18, 0.51±0.41, and 0.59±0.52 μmol/L for the conventional, FLACS, and FLACS-N groups (P=0.42). After phacoemulsification, the PGE2 and MDA levels increased in all groups. The MDA induction was significantly correlated with the phacoemulsification time (P=0.002). The postoperative flare was insignificantly higher in the FLACS than conventional group.
Conclusions: Compared to conventional phacoemulsification, LDV FLACS induced a significantly higher PGE2 level. The MDA and postoperative aqueous flare level were insignificantly higher. Preoperative NSAID reduced the PGE2 surge and occurrence of intraoperative miosis. The oxidative stress induced during phacoemulsification was strongly correlated with phacoemulsification time.

Changes in aqueous oxidative stress, prostaglandin, and cytokines: Comparisons of low-energy femtosecond laser-assisted cataract surgery versus conventional phacoemulsification Changes in aqueous oxidative stress, prostaglandin, and cytokines: Comparisons of low-energy femtosecond
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2019-02-04T12:38:16Z
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