Correlation between preoperative aqueous cytokine levels and mid-term corneal endothelial cell loss following penetrating keratoplasty.

OBJECTIVE

To investigate the association between preoperative aqueous humour (AqH) cytokines and mid-term endothelial cell density (ECD) following penetrating keratoplasty (PKP).

METHODS

This study analysed a total of 87 eyes of which 54 underwent PKP and 33 eyes underwent cataract surgery. AqH samples were collected at the beginning of surgery. The levels of cytokines (interleukins [ILs]-1α, -1β, -4, -6, -8, -10, -17A, monocyte chemotactic protein [MCP]-1, interferon [IFN]-α, IFN-γ, E-selectin, P-selectin, and soluble intercellular adhesion molecule-1 [sICAM-1]) in the AqH were measured using a multiplex beads immunoassay. The subjects who underwent PKP were classified into two groups: Group 1: ECD < 1200 cells/mm at 36 months and graft failure during follow-up (38 eyes); Group 2 ECD ≥ 1200 cells/mm at 36 months (16 eyes).

RESULTS

The ECD reduction per year was significantly correlated with the preoperative levels of protein (r = 0.48; P < 0.001), IL-6 (r = 0.29; P = 0.048), IL-8 (r = 0.42; P = 0.003), IL-12p70 (r = 0.46; P = .007), MCP-1 (r = 0.28; P = 0.049), IFN -γ (r = 0.43; P = 0.008), and s-ICAM-1 (r = 0.30; P = 0.03). The preoperative levels of IL-8, and IFN-γ in AqH were significantly higher in eyes with ECD < 1200 cells/mm compared to those with ECD ≥ 1200 cells/mm at 3 years (P ≤ 0.02).

CONCLUSION

Preoperative AqH cytokine levels are associated with mid-term ECD reduction after PKP. Pathological alterations of the AqH microenvironment may affect mid-term corneal endothelial cell survival.