眼手术后泪液和补体激活产物。

Tear fluid and complement activation products in tears after ocular surgery.

机构信息

Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan.

Department of Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan.

出版信息

BMC Ophthalmol. 2023 Jul 18;23(1):329. doi: 10.1186/s12886-023-03037-6.

DOI:10.1186/s12886-023-03037-6

PMID:37464366

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10355014/

Abstract

PURPOSE

Due to technological advancements, surgical invasiveness has been reduced. However, cataract surgery has been implicated in causing postoperative inflammation, including dry eye syndrome. The innate immune system may be involved in postoperative inflammation, and complement activation could potentially play a crucial role in defense against pathogens, homeostasis, and wound healing. To investigate changes in the tear film complement activation products (CAPs) and ocular surface after vitrectomy combined with cataract surgery.

METHODS

Forty-three patients (23 women; median age, 69 years) were enrolled in this prospective study and underwent phacoemulsification and vitrectomy. We measured Schirmer's test (ST) and CAPs in the tears at baseline (the day before surgery), 4 days and 1 month after the surgery. Tears were collected in microtubes. The CAPs in the tear fluid were analyzed by cytometric bead array.

RESULTS

The median ST (8.5 mm) at baseline increased to 16 mm at 4 days ( P < 0.001) and 10 mm at 1 month (P = 0.44). The C3a levels (1202 pg/ml) at baseline increased to 2753 pg/ml at 4 days (P < 0.001), and 1763 pg/ml at 1 month (P = 0.049). The C4a levels (476 pg/ml) at baseline increased to 880 pg/ml at 4 days (P < 0.001), and 657 pg/ml at 1 month (P = 0.013). The C5a levels (22.6 pg/ml) at baseline increased to 470.9 pg/ml at 4 days (P < 0.001), and 38.3 pg/ml at 1 month (P = 0.0048). The surgical eyes were divided into the short ST group (≦ 10 mm, n = 22) and long ST group (> 10 mm, n = 21) based on the preoperative ST values. At 1 month postoperatively, the C3a levels were 2194 pg/ml in the preoperative short ST group and 1391 pg/ml in the long ST group, with significantly higher C3a concentrations in the short ST group (P < 0.001).

CONCLUSIONS

The CAPs levels in tears increased after vitrectomy combined with cataract surgery. A preoperative deficit in tear secretion might induce prolonged complement activation and delayed recovery of ocular surface parameters postoperatively.

摘要

目的

由于技术进步，手术的侵袭性已降低。然而，白内障手术已被牵连引起术后炎症，包括干眼症。先天免疫系统可能参与术后炎症，补体激活可能在防御病原体、维持内环境稳定和伤口愈合方面发挥关键作用。研究玻璃体切割联合白内障手术后泪膜补体激活产物 (CAPs) 和眼表的变化。

方法

43 名患者（23 名女性；中位年龄 69 岁）纳入本前瞻性研究并接受白内障超声乳化吸除术和玻璃体切除术。我们在术前（手术前一天）、术后 4 天和 1 个月测量 Schirmer 试验 (ST) 和泪液中的 CAPs。泪液收集在微量管中。通过流式细胞术微珠阵列分析泪液中的 CAPs。

结果

基线时的中位 ST（8.5mm）增加至术后 4 天的 16mm（P<0.001）和 1 个月时的 10mm（P=0.44）。基线时的 C3a 水平（1202pg/ml）增加至术后 4 天的 2753pg/ml（P<0.001）和 1 个月时的 1763pg/ml（P=0.049）。基线时的 C4a 水平（476pg/ml）增加至术后 4 天的 880pg/ml（P<0.001）和 1 个月时的 657pg/ml（P=0.013）。基线时的 C5a 水平（22.6pg/ml）增加至术后 4 天的 470.9pg/ml（P<0.001）和 1 个月时的 38.3pg/ml（P=0.0048）。根据术前 ST 值，将手术眼分为短 ST 组（≦10mm，n=22）和长 ST 组（>10mm，n=21）。术后 1 个月，术前短 ST 组的 C3a 水平为 2194pg/ml，长 ST 组为 1391pg/ml，短 ST 组的 C3a 浓度明显更高（P<0.001）。