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Influence of argon laser trabeculoplasty on transforming growth factor-beta 2 concentration and bleb scarring following trabeculectomy

  • Clinical Investigation
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Abstract

Background

The purpose of this study was to evaluate the influence of previous argon laser trabeculoplasty (ALT) on transforming growth factor-beta 2 (TGF-beta 2) concentration of the aqueous humor and its influence on bleb scarring after trabeculectomy.

Methods

Fifty-one patients with primary open-angle glaucoma (POAG) and 29 patients with exfoliation (XFS) glaucoma were recruited for this prospective study before undergoing trabeculectomy. Sixty to 200 µl of aqueous humor were analyzed for total and biologically active TGF-beta 2 concentrations (R and D Systems). TGF-beta 2 levels and a standardized bleb assessment were compared between the ALT- and non-ALT-treated groups.

Results

POAG eyes without ALT showed significantly higher total TGF-beta 2 levels (2,317.7±1,041.1 pg/ml) than eyes with previous ALT (1,621.6±899.6 pg/ml; P=0.026). No significant difference was found for active TGF-beta 2 levels (ALT: 238.1±119.0 pg/ml; no ALT: 220.1±96.9 pg/ml; P=0.585). In XFS patients ALT did not alter total TGF-beta 2 levels (ALT: 1,524.9±624.9 pg/ml, no ALT: 1,220±499.1 pg/ml; P=0.20), but active TGF-beta 2 was significantly higher in the ALT-treated (237.0±99.7 pg/ml) than in the non-ALT-treated (140.0±95.3 pg/ml, P=0.028) group. Bleb grading revealed no statistical difference between the ALT- and non-ALT-treated groups in POAG (P=0.545, Fisher's exact test), whereas XFS patients with ALT were at increased risk for scarring compared to non-ALT-treated patients (P=0.053).

Conclusions

ALT appears to increase the risk of scarring in XFS patients because of increased levels of activated TGF-beta 2.

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Acknowledgements

We thank the Department of Neurology, Wuerzburg (Dr. P.Rieckmann, B. Meyer), for laboratory assistance and Dr. W. Sabisch for assistance with statistics.

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Authors and Affiliations

  1. Department of Ophthalmology, Julius Maximilian University Würzburg, Joseph-Schneider-Str. 11, 97080, Würzburg, Germany

    Iris Wimmer, Greda Picht & Franz Grehn

  2. Department of Ophthalmology, Ludwig Maximilian University Munich, Mathildenstrasse 8, 80336, München, Germany

    Ulrich Welge-Luessen

Authors
  1. Iris Wimmer
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  2. Ulrich Welge-Luessen
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  3. Greda Picht
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  4. Franz Grehn
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Correspondence to Iris Wimmer.

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All human studies have been reviewed by the Ethics Committee of the University of Wuerzburg and have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. All persons gave their informed consent prior to their inclusion in the study. The manuscript will not be published elsewhere in any language without the consent of the copyright holders, the right of third parties will not be violated and the publisher will not be held legally responsible should there be any claims for compensation.

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Wimmer, I., Welge-Luessen, U., Picht, G. et al. Influence of argon laser trabeculoplasty on transforming growth factor-beta 2 concentration and bleb scarring following trabeculectomy. Graefe's Arch Clin Exp Ophthalmol 241, 631–636 (2003). https://doi.org/10.1007/s00417-003-0721-x

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  • DOI: https://doi.org/10.1007/s00417-003-0721-x

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