Abstract
We previously reported marked elevation of glutamate, gamma-aminobutyric acid (GABA) and alanine in the vitreous after combined cataract surgery and vitrectomy for macular disorder. Photo-stimulation by the operating microscope and increased intraocular pressure (IOP) are possible causes of postoperative increases in amino acids. An animal model was used to verify this hypothesis. Forty-five coloured rabbits were studied; stress was applied to simulate cataract surgery. Simultaneous photic and pressure stress, photic stress alone, or pressure stress alone were exerted for 20 mins. The vitreous was extracted at the end of the stress period, or 10 mins or 30 mins later. Levels of six amino acids (asparate, glutamate, glycine, taurine, alanine and GABA) in the vitreous were analysed quantitatively. Significant increases in vitreous glutamate concentrations in treated eyes were observed following simultaneous photic and pressure stress, as well as after pressure stress alone, whereas no difference was found after photic stress alone. The mean glutamate concentrations in treated eyes and fellow eyes, respectively, were 5.59 +/- 2.03 microM and 4.36 +/- 2.09 microM (p < or = 0.05) 10 mins after simultaneous photic and pressure stress, and 4.32 +/- 0.97 microM and 2.29 +/- 0.51 microM (p < 0.05) 10 mins after pressure stress alone. Taurine concentration was elevated by pressure stress alone at 0 min and at 10 mins post-stress. Alanine concentration was reduced by photic stress alone at 10 mins post-stress. In all protocols, no significant differences between treated and fellow eyes were observed at 30 mins after stress. Time-dependent changes were observed not only in the treated eyes, but also in untreated fellow eyes. Elevations of vitreous glutamate in cataract surgery may be caused by pressure stress due to irrigation. Photic stress caused by the operating microscope has little influence. Sympathetic response may be involved in amino acid changes due to stress in cataract surgery.
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