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Consensual inflammation following ocular surgery
S M El-Harazi1, R M Feldman, R S Ruiz
1Department of Ophthalmology and Visual Science, University of Texas Health Science Center, Houston, USA.
Insights
Subclinical inflammation was detected in the non-operated eye after cataract surgery (phacoemulsification) or glaucoma surgery (trabeculectomy). This consensual inflammatory response returned to baseline levels by 28 days post-operation.
Area of Science:
- Ophthalmology
- Inflammation Research
- Surgical Outcomes
Background:
- Unilateral ocular surgery, such as phacoemulsification or trabeculectomy, may potentially elicit a response in the contralateral, non-operated eye.
- Understanding this potential consensual response is crucial for comprehensive patient care and managing post-operative inflammation.
Purpose of the Study:
- To investigate the occurrence and extent of a consensual inflammatory response in the non-operated eye following unilateral phacoemulsification or trabeculectomy in human subjects.
- To quantify inflammatory markers in both the operated and non-operated eyes over a 28-day post-operative period.
Main Methods:
- Sixty patients undergoing unilateral phacoemulsification or trabeculectomy were enrolled.
- Laser flare photometry and cell counting were used to measure ocular inflammation in both eyes pre-operatively and on post-operative days 1, 7, and 28.
- Regression analysis and correlation were employed to analyze the data and identify factors influencing inflammation in the non-operated eye.
Main Results:
- A statistically significant, albeit small, increase in flare and cell counts was observed in the non-operated eye on post-operative day 1 (P<0.001).
- Elevated inflammation levels persisted in the non-operated eye at post-operative day 7 (P<0.001).
- Inflammatory markers in the non-operated eye returned to pre-operative levels by post-operative day 28.
Conclusions:
- Subclinical inflammation occurs in the non-operated eye subsequent to unilateral phacoemulsification and trabeculectomy.
- The precise mechanisms driving this consensual inflammatory response require further investigation.
Purpose:
To determine whether a consensual inflammatory response occurs following unilateral phacoemulsification or trabeculectomy in humans.
Methods:
Sixty patients undergoing phacoemulsification or primary trabeculectomy were included in the study. Some patients were randomly assigned to have a shield placed on the non-operated eye during surgery. The Kowa laser flare meter (FM-500) and laser cell counter (LC-500) (Kowa Electronics and Optics, Tokyo, Japan) were used to assess the inflammatory response in both eyes. Measurements were taken preoperatively and on postoperative days 1, 7 and 28. The regression analysis with random model effect was used to identify factors which may affect the change of flare and cells in the non-operated eye after surgery. Correlation was evaluated between the inflammatory responses of the paired eyes. A P<0.05 was considered statistically significant for all analyses.
Results:
The flare and cells in the non-operated eye showed a small, but significant, increase on day 1 (mean flare increased 2.68 photons/ms from preoperative level with P<0.001 and mean cells increased 2.49 cells/0.5 mm3 from preoperative level with P<0.0001). At day 7 the amount of inflammation was still elevated (mean flare increased 0.41 photons/ms from preoperative level with P<0.001 and mean cells increased 0.63 cells/0.5 mm3 from preoperative level with P<0.001). By day 28, the amount of inflammation in the nonoperated eyes returned to preoperative levels.
Conclusions:
Subclinical inflammation occurs in the non-operated eye following phacoemulsification and trabeculectomy. The etiology of this finding has yet to be elucidated.