Blood-aqueous barrier integrity in patients with Graves' ophthalmopathy (GO), before and after rehabilitative surgery.

Abstract

The study was conducted to analyze aqueous flare and its correlations in patients with Graves' ophthalmopathy (GO) undergoing orbital decompression, extraocular muscle, and eyelid surgery. Prospective interventional case series. Forty-eight eyes of 27 patients (20 female and 7 male, aged 54.4 ± 5.7) undergoing surgical treatment for GO. Eighteen eyes of nine patients (aged 55.3 ± 3.6) undergoing orbital decompression. Nineteen eyes of 11 patients (aged 54.7 ± 5.6) undergoing extraocular muscle surgery and 13 eyes of 7 patients (aged 53.9 ± 4.9) undergoing eyelid surgery and control group (34 patients aged 53.9 ± 5.1). Laser flare analysis and clinical assessment were performed before surgery and at 1 day, 7 days, and 3 months following surgery. Aqueous flare was significantly higher in patients with GO (14.03 ± 8.45) before intervention than in the control group (7.89 ± 3.56) (P<0.001), and correlated with Clinical Activity Score and intraocular pressure. In the patients undergoing orbital decompression, flare increased from 17.77 ± 10.63 pc/ms to 38.32 ± 13.56 pc/ms on the first day and 41.31 ± 17.19 pc/ms on the seventh day and returned to 16.01 ± 8.58 pc/ms in 3 months. In patients undergoing extraocular muscle surgery flare increased from 13.05 ± 6.50 to 23.04 ± 11.53 pc/ms (P<0.001) on the first day and returned to 18.02 ± 14.09 pc/ms on the seventh day. Eyelid surgery did not change flare values. Orbital decompression disrupts blood-aqueous barrier (BAB). The integrity of BAB returns to preoperative status within 3 months. Extraocular muscle surgery mildly affects BAB integrity, and the effect subsides within 7 days. Eyelid surgery does not affect BAB.