RS Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation, SankaraNethralaya, Chennai, India.
Elite School of Optometry, Medical Research Foundation, SankaraNethralaya, Chennai, India.
PLoS One. 2020 May 21;15(5):e0233517. doi: 10.1371/journal.pone.0233517. eCollection 2020.
Vitreo-retinal (VR) surgeries induce conjunctival changes. However, there are no study reports regarding prevalence and severity of dry eye after these surgeries. This study evaluated dry eye outcome after VR surgery. Patients undergoing VR surgery classified as scleral buckle and microincision vitrectomy surgery (n = 44, mean age: 56.09±10.2 years) were recruited. Dry eye evaluation was done before and 8 weeks after surgery (2 weeks after omitting topical eye drops). Conjunctival imprint cytology for goblet cell count and tear Mucin 5AC (MUC5AC) protein estimation was done. Gene expressions of MUC5AC, MUC4, MUC16, Aquaporin 4 (AQP4) and AQP5 were analyzed in the conjunctival imprint cells by qPCR. None of the patients exhibited clinical signs of dry eye after VR surgery. But the conjunctival goblet cell density (GCD) was significantly lowered post-VR surgery (63% cases, **p = 0.012) with no alterations in the tear MUC5AC protein. Post-VR surgery, the conjunctival cell gene expression of MUC4, MUC16 and AQP4 were significantly increased (*p = 0.025, *p = 0.05 and *p = 0.02 respectively) and AQP5 was significantly lowered (*p = 0.037), with no change in MUC5AC expression. Tear cytokines were significantly increased post-VR surgery (anti-inflammatory: IL1RA, IL4, IL5, IL9, FGF; PDGFbb and pro-inflammatory: IL2, IL6, IL15, GMCSF and IFNg). Though clinical signs of dry eye were not observed after VR surgery, ocular surface changes in the form of reduced GCD, altered MUC5AC, MUC4, MUC16, AQP4, AQP5 and cytokines are suggestive of dry eye outcome at the molecular level especially inpatients aged above 51 years, especially female gender and those who are diabetic.
玻璃体视网膜 (VR) 手术会引起结膜变化。然而，目前尚无关于这些手术后干眼症的患病率和严重程度的研究报告。本研究评估了 VR 手术后干眼症的结果。招募了接受 VR 手术的患者，分为巩膜扣带和微切口玻璃体切除术 (n = 44，平均年龄：56.09±10.2 岁)。在手术前和手术后 8 周（停止使用局部眼药水 2 周后）进行干眼症评估。进行结膜印模细胞学检查以评估杯状细胞计数和泪液黏蛋白 5AC (MUC5AC) 蛋白。通过 qPCR 分析结膜印模细胞中 MUC5AC、MUC4、MUC16、水通道蛋白 4 (AQP4) 和 AQP5 的基因表达。VR 手术后，所有患者均未出现干眼症的临床症状。但是 VR 手术后结膜杯状细胞密度 (GCD) 明显降低 (63%的病例，**p = 0.012)，而泪液 MUC5AC 蛋白无变化。VR 手术后，结膜细胞中 MUC4、MUC16 和 AQP4 的基因表达明显增加 (*p = 0.025，*p = 0.05 和 *p = 0.02 分别)，AQP5 明显降低 (*p = 0.037)，而 MUC5AC 表达无变化。VR 手术后泪液细胞因子明显增加 (抗炎：IL1RA、IL4、IL5、IL9、FGF；PDGFbb 和促炎：IL2、IL6、IL15、GMCSF 和 IFNg)。尽管 VR 手术后没有观察到干眼症的临床症状，但 GCD 减少、MUC5AC、MUC4、MUC16、AQP4、AQP5 和细胞因子改变等眼表变化表明分子水平上存在干眼症结果，尤其是年龄在 51 岁以上、女性和糖尿病患者。
