Abstract
Purpose. Undertake a comparative analysis of the level of pro-inflammatory cytokines (IL-8, MCP-1, ICAM-1) in tear of patients with advanced proliferative diabetic retinopathy and complicated primary cataract after phacoemulsification surgery and IOL implantation with vitreoretinal surgery accomplished at once in comparison with vitreoretinal surgery only. Material and methods. 34 cases of surgery treatment of patients with PDR and complicated primary cataract were enrolled. This patients were divided into two groups depending on the treatment tactics. In the 1st group patients were subjected to a two-step surgical procedure: vitreoretinal surgery(VRS) with silicone oil tamponade performed as the first step in their treatment; followed by the second step, phacoemulsification surgery and silicone oil removal, and the IOL implantation, respectively. In the 2 nd group phacoemulsification performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity. On the 2 nd day after the first step surgery and before surgical treatment the tear samples of the patients of both groups have been examined. Results. At the early postoperative period after VRS, an increase in the inflammatory reaction was observed in patients of both groups by the 2 nd day, while the severity of the inflammatory reaction was significantly higher in the 2 nd group patients (p < 0,001) relative to the 1 st group patients. A concentration of the following cytokines: IL-8, MCP-1, ICAM-1 in the 2 nd group was 2,5–5 times higher than in the 1 st group. In the 2 nd group patients, there was a statistically significant correlation between the development of NVH in the long-term postoperative period and the level of IL-8, MCP-1, ICAM-1 in tear on the 2 nd day after the first step surgery (p = 0.015). Conclusion. The research revealed that the patients with advanced PDR are accurately determined by the increased concentration of IL-8, MCP-1, ICAM-1 in tear after phacoemulsification surgery and IOL implantation with vitreoretinal surgery accomplished at once in comparison with vitreoretinal surgery only. Keywords: cytokines, diabetic retinopathy, cataract, vitreoretinal surgery.
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