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Effect of preoperative eyedrops on cytokine concentrations in aqueous humor of patients undergoing femtosecond laser–assisted cataract surgery

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Abstract

Purpose

To compare the anti-inflammatory activity of preoperatively applied eyedrops, as determined by cytokine concentrations in aqueous humor collected during surgery in patients undergoing femtosecond laser–assisted cataract surgery.

Methods

A total of 120 patients undergoing femtosecond laser–assisted cataract surgery were randomly assigned to four groups of 30 patients each. Groups were administered 0.1% fluorometholone eyedrops, 0.45% ketorolac tromethamine eyedrops, both 0.1% fluorometholone and 0.45% ketorolac tromethamine eyedrops, or no eyedrops. Eyedrops were instilled 1 h, 20 min, and just before surgery. After anterior capsulotomy and nuclear fragmentation using a femtosecond laser, 0.1 cc aqueous humor was obtained using a needle and syringe. Cytokine and prostaglandin E2 (PGE2) concentrations were quantitatively determined.

Results

The 120 patients included 59 men and 61 women, of mean age 65.02 years. The mean interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations after treatment did not differ significantly in the four groups. The average interleukin-8 (IL-8) concentrations were significantly lower in the fluorometholone (4.80 pg/mL), ketorolac tromethamine (4.84 pg/mL), and fluorometholone + ketorolac tromethamine (4.68 pg/mL) groups than in the control group (6.83 pg/mL). Furthermore, the average PGE2 concentrations were significantly lower in the ketorolac tromethamine (270.04 pg/mL) and fluorometholone + ketorolac tromethamine (239.00 pg/mL) groups, but not in the fluorometholone (393.16 pg/mL) group, than in the control group (472.36 pg/mL).

Conclusion

Preoperative fluorometholone instillation reduced IL-8, and ketorolac tromethamine instillation reduced IL-8 and PGE2, in aqueous humor of patients undergoing femtosecond laser surgery, with the combination of both eyedrops being more effective than either alone.

Trial registration

KCT0005717

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

Code availability

Not applicable.

References

  1. Day AC, Burr JM, Bennett K, Dore CJ, Bunce C, Hunter R, Nanavaty MA, Balaggan KS, Wilkins MR, FACT trial group, (2020) Femtosecond laser-assisted cataract surgery compared with phacoemulsification cataract surgery: randomized noninferiority trial with 1-year outcomes. J Cataract Refract Surg 46:1360–1367

    Article  Google Scholar 

  2. Jun JH, Yoo YS, Lim SA, Joo CK (2017) Effects of topical ketorolac tromethamine 0.45% on intraoperative miosis and prostaglandin E2 release during femtosecond laser-assisted cataract surgery. J Cataract Refract Surg 43:492–497

    Article  Google Scholar 

  3. Wang L, Zhang Z, Koch DD, Jia Y, Cao W, Zhang S (2016) Anterior chamber interleukin 1 β, interleukin 6 and prostaglandin E2 in patients undergoing femtosecond laser-assisted cataract surgery. Br J Ophthalmol 100:579–582

    Article  Google Scholar 

  4. Schultz T, Joachim SC, Kuehn M, Dick HB (2013) Changes in prostaglandin levels in patients undergoing femtosecond laser-assisted cataract surgery. J Refract Surg 29:742–747

    Article  Google Scholar 

  5. Chen H, Lin H, Zheng D, Liu Y, Chen W, Liu Y (2015) Expression of cytokines, chemokines and growth factors in patients undergoing cataract surgery with femtosecond laser pretreatment. PLoS One 10:e0137227

    Article  Google Scholar 

  6. Diakonis VF, Anagnostopoulos AG, Moutsiopoulou A, Yesilirmak N, Cabot F, Waren DP, O’Brien TP, Yoo SH, Weinstock RJ, Donaldson KE (2018) The effect of NSAID pretreatment on aqueous humor prostaglandin E2 concentration in eyes undergoing femtosecond laser-assisted capsulotomy. J Ophthalmol 2018:1891249

    PubMed  PubMed Central  Google Scholar 

  7. Schultz T, Joachim SC, Szuler M, Stellbogen M, Dick HB (2015) NSAID pretreatment inhibits prostaglandin release in femtosecond laser-assisted cataract surgery. J Refract Surg 31:791–794

    Article  Google Scholar 

  8. Kiss HJ, Takacs AI, Kranitz K, Sandor GL, Toth G, Gilanyi B, Nagy ZZ (2016) One-day use of preoperative topical nonsteroidal anti-inflammatory drug prevents intraoperative prostaglandin level elevation during femtosecond laser-assisted cataract surgery. Curr Eye Res 41:1064–1067

    Article  CAS  Google Scholar 

  9. Anisimova NS, Arbisser LB, Petrovski G, Petrichuk SV, Sobolev NP, Petrovski B, Borsenok SA, Komah YA, Malyugin BE (2018) Effect of NSAIDs on pupil diameter and expression of aqueous humor cytokines in FLACS versus conventional phacoemulsification. J Refract Surg 34:646–652

    Article  Google Scholar 

  10. Bali SJ, Hodge C, Lawless M, Roberts TV, Sutton G (2012) Early experience with the femtosecond laser for cataract surgery. Ophthalmology 119:891–899

    Article  Google Scholar 

  11. Hashemi H, Seyedian MA, Mohammadpour M (2015) Small pupil and cataract surgery. Curr Opin Ophthalmol 26:3–9

    Article  Google Scholar 

  12. Joseph J, Wang HS (1993) Phacoemulsification with poorly dilated pupils. J Cataract Refract Surg 19:551–556

    Article  CAS  Google Scholar 

  13. Conrad-Hengerer I, Hengerer FH, Al Juburi M, Schultz T, Dick HB (2014) Femtosecond laser-induced macular changes and anterior segment inflammation in cataract surgery. J Refract Surg 30:222–226

    Article  Google Scholar 

  14. Levitz L, Reich J, Roberts TV, Lawless M (2015) Incidence of cystoid macular edema: femtosecond laser-assisted cataract surgery versus manual cataract surgery. J Cataract Refract Surg 41:683–686

    Article  Google Scholar 

  15. Vane JR, Botting RM (1998) Mechanism of action of nonsteroidal anti-inflammatory drugs. Am J Med 104:2S-8S (discussion 21S-22S)

    Article  CAS  Google Scholar 

  16. Keulen-de Vos HC, van Rij G, Renardel de Lavalette JC, Jansen JT (1983) Effect of indomethacin in preventing surgically induced miosis. Br J Ophthalmol 67:94–96

    Article  CAS  Google Scholar 

  17. Li Q, Luyo D, Matteson DM, Chan CC (1998) Suppressive effect of antiflammin-2 on compound 48/80-induced conjunctivitis. Role of phospholipase A2s and inducible nitric oxide synthase. Ocul Immunol Inflamm 6:65–73

    Article  CAS  Google Scholar 

  18. McColgin AZ, Heier JS (2000) Control of intraocular inflammation associated with cataract surgery. Curr Opin Ophthalmol 11:3–6

    Article  CAS  Google Scholar 

  19. El-Harazi SM, Feldman RM (2001) Control of intra-ocular inflammation associated with cataract surgery. Curr Opin Ophthalmol 12:4–8

    Article  CAS  Google Scholar 

  20. Matzinger P (2002) The danger model: a renewed sense of self. Science 296:301–305

    Article  CAS  Google Scholar 

  21. Chu L, Wang B, Xu B, Dong N (2013) Aqueous cytokines as predictors of macular edema in non-diabetic patients following uncomplicated phacoemulsification cataract surgery. Mol Vis 19:2418–2425

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Mesquida M, Leszczynska A, Llorenç V, Adán A (2014) Interleukin-6 blockade in ocular inflammatory diseases. Clin Exp Immunol 176:301–309

    Article  CAS  Google Scholar 

  23. Gu R, Zhou M, Jiang C, Yu J, Xu G (2016) Elevated concentration of cytokines in aqueous in post-vitrectomy eyes. Clin Exp Ophthalmol 44:128–134

    Article  Google Scholar 

  24. Hernandez C, Segura RM, Fonollosa A, Carrasco E, Francisco G, Simo R (2005) Interleukin-8, monocyte chemoattractant protein-1 and IL-10 in the vitreous fluid of patients with proliferative diabetic retinopathy. Diabet Med 22:719–722

    Article  CAS  Google Scholar 

  25. Balaiya S, Edwards J, Tillis T, Khetpal V, Chalam KV (2011) Tumor necrosis factor-alpha (TNF-α) levels in aqueous humor of primary open angle glaucoma. Clin Ophthalmol 5:553–556

    Article  CAS  Google Scholar 

  26. Meacock WR, Spalton DJ, Stanford MR (2000) Role of cytokines in the pathogenesis of posterior capsule opacification. Br J Ophthalmol 84:332–336

    Article  CAS  Google Scholar 

  27. Prada J, Ngo-Tu T, Baatz H, Hartmann C, Pleyer U (2000) Detection of tumor necrosis factor alpha and interleukin 1 alpha gene expression in human lens epithelial cells. J Cataract Refract Surg 26:114–117

    Article  CAS  Google Scholar 

  28. Ambache NP, Brummer HC (1968) A simple chemical procedure for distinguishing E from F prostaglandins, with application to tissue extracts. Br J Pharmacol Chemother 33:162–170

    Article  CAS  Google Scholar 

  29. Hall DW, Bonta IL (1977) Prostaglandins and ocular inflammation. Doc Ophthalmol 44:421–434

    Article  CAS  Google Scholar 

  30. Schultz T, Joachim SC, Stellbogen M, Dick HB (2015) Prostaglandin release during femtosecond laser-assisted cataract surgery: main inducer. J Refract Surg 31:78–81

    Article  Google Scholar 

  31. Musleh MG, Bokre D, Dahlmann-Noor AH (2020) Risk of intraocular pressure elevation after topical steroids in children and adults: a systematic review. Eur J Ophthalmol 30:856–866

    Article  Google Scholar 

  32. Beck LS, Deguzman L, Lee WP, Xu Y, McFatridge LA, Amento EP (1991) TGF-beta 1 accelerates wound healing: reversal of steroid-impaired healing in rats and rabbits. Growth Factors 5:295–304

    Article  CAS  Google Scholar 

  33. Wu YT, Truong TN, Tam C, Mendoza MN, Zhu L, Evans DJ, Fleiszig SMJ (2019) Impact of topical corticosteroid pretreatment on susceptibility of the injured murine cornea to Pseudomonas aeruginosa colonization and infection. Exp Eye Res 179:1–7

    Article  CAS  Google Scholar 

  34. Rigas B, Huang W, Honkanen R (2020) NSAID-induced corneal melt: clinical importance, pathogenesis, and risk mitigation. Surv Ophthalmol 65:1–11

    Article  Google Scholar 

  35. Aragona P, Stilo A, Ferreri F, Mobrici M (2005) Effects of the topical treatment with NSAIDs on corneal sensitivity and ocular surface of Sjögren’s syndrome patients. Eye (Lond) 19:535–539

    Article  CAS  Google Scholar 

  36. Chen H, Lin H, Chen W, Zhang B, Xiang W, Li J, Chen W (2017) Topical 0.1% bromfenac sodium for intraoperative miosis prevention and prostaglandin E2 inhibition in femtosecond laser-assisted cataract surgery. J Ocul Pharmacol Ther 33:193–201

    Article  CAS  Google Scholar 

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Acknowledgements

The authors thank Sae-Byeok Hwang and Soon-Suk Kang for their contribution to the data analysis.

Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology (2020R1F1A1073627); by the Research and Business Development Program through the Korea Institute for Advancement of Technology (KIAT), funded by the Ministry of Trade, Industry and Energy (MOTIE) (grant number, P0014063); and by a grant from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea (2019IP0049-1, 2020IP0045-3).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, HanGil Eye Hospital, Incheon, Republic of Korea

    Jae Hyuck Lee

  2. Department of Ophthalmology, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea

    Jae Hyuck Lee

  3. Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea

    Ho Seok Chung

  4. Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea

    Su Young Moon, Jooyoung Yoon, Koeun Lee, Hun Lee, Jae Yong Kim, Hyun Taek Lim & Hungwon Tchah

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  1. Jae Hyuck Lee
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  2. Ho Seok Chung
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Contributions

JHL: study supervision, concept and study design, data collection, data interpretation, data analysis and statistics, drafting, revision and final approval of manuscript

HSC: concept and study design, data collection, data interpretation, data analysis and statistics

SYM: Data collection, data interpretation, data analysis and statistics, drafting

JY: data collection, drafting

KL: data collection, drafting

HL: data collection, data analysis and statistics

JYK: study supervision, revision and final approval of manuscript

HTL: study supervision, revision and final approval of manuscript

HT: study supervision, concept and study design, data interpretation, revision and final approval of manuscript.

Corresponding author

Correspondence to Hungwon Tchah.

Ethics declarations

Ethics approval

This study adhered to the tenets of the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Asan Medical Center (Seoul, Republic of Korea).

Consent to participate

Written informed consent forms were signed by all study participants prior to the procedure.

Consent for publication

Written informed consent forms for publication of the research were signed by all study participants prior to the procedure.

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The authors declare no competing interests.

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Lee, J.H., Chung, H.S., Moon, S.Y. et al. Effect of preoperative eyedrops on cytokine concentrations in aqueous humor of patients undergoing femtosecond laser–assisted cataract surgery. Graefes Arch Clin Exp Ophthalmol 260, 885–891 (2022). https://doi.org/10.1007/s00417-021-05428-1

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  • DOI: https://doi.org/10.1007/s00417-021-05428-1

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