Определение цитокинов в сыворотке крови и во влаге передней камеры у пациентов с глаукомой и катарактой на фоне псевдоэксфолиативного синдрома

Abstract

Purpose. To investigate changes in proinflammatory cytokines Interleukin (IL 1β) and Tumor necrosis factor (TNF-α) before surgery in anterior chamber moisture and in blood serum in cataract and in its combination with glaucoma due to pseudoexfoliative syndrome (PES). Material and methods. The results of the examination included 61 patients aged 56 to 86 years (average age 72.2 years) who were hospitalized for cataract surgery. Among them, 12 (19.7 %) people had primary open-angle pseudoexfoliative glaucoma with normalized intraocular pressure (IOP). A group of 34 patients were diagnosed with PES, but without the presence of glaucoma. The control group consisted of 15 patients with cataracts of comparable age without signs of PES. The analysis of the results took into account the data of ophthalmological examination, immunological studies, namely measurements of the concentration of IL-1ß and TNFa in blood serum and in the moisture of the anterior chamber, as well as somatic status. Results. PES, in general (i.e. in the study of 46 patients), occurred in 23.9 % of cases, stage II — in 43.5 % and stage III — in 32.6%. With a combination of cataracts and glaucoma (in the advanced stage), PES stage I was diagnosed more often — in 33.3 %.Inflammatory postoperative complications were diagnosed only in stages II or III of PES, and more often with a combination of glaucoma and cataract (in 33.3 % of cases) than with isolated surgical treatment of cataract (11.8 %). There was a statistically significant (p < 0.05) increase in the indicators of proinflammatory cytokines IL- 1ß and TNF-α in blood serum and especially in the moisture of the anterior chamber in patients with PES in comparison with the age control group. Various concomitant somatic pathologies in patients with PES, especially in the presence of glaucoma, occurred more often (93.5 %) than in patients without pseudoexfoliation (73.3 %). Conclusion. Significantly increased, in comparison with the control rate, concentrations of proinflammatory cytokines IL-1β and TNFa in blood serum and moisture of the anterior chamber of the eyes with unoperated cataract, and especially when combined with glaucoma due to PES, correlated with the degree of its development and the risk of postoperative, including inflammatory, complications. Taking into account more frequent presence of somatic pathology in patients with PES, it is necessary to have more frequent dynamic follow-up after surgery of patients with PES for the purpose of early diagnosis and timely treatment of potential complications. Keywords: cataract, glaucoma, surgical treatment, pseudoexfoliative syndrome, proinflammatory cytokines Interleukin (IL-1β) and Tumor necrosis factor (TNF-α), postoperative, inflammatory complications