rss
Br J Ophthalmol 2006;90:697-701 doi:10.1136/bjo.2005.087403
  • Clinical science
    • Scientific reports

Diabetic cataract removal: postoperative progression of maculopathy—growth factor and clinical analysis

  1. J I Patel1,2,
  2. P G Hykin2,
  3. I A Cree1
  1. 1Institute of Ophthalmology, London, UK
  2. 2Moorfields Eye Hospital, London, UK
  1. Correspondence to: MrJ I Patel Department of Pathology, Institute of Ophthalmology, 11–43 Bath Street, London EC1V 9EL, UK; jigs37{at}hotmail.com
  • Accepted 23 February 2006
  • Published Online First 15 March 2006

Abstract

Background: Diabetic cataract extraction can be frequently complicated by macular oedema, progression of retinopathy, or development of iris neovascularisation. The pathogenesis of these complications may be the result of changes in the concentration of angiogenic and anti-angiogenic cytokines in the immediate postoperative period. The study aims to prospectively analyse this.

Methods: Uneventful phacoemulsification with intraocular lens implant was performed in seven eyes of six patients with diabetic retinopathy ranging from severe non-proliferative to quiescent proliferative. Patients were reviewed 1 day, 1 week, 1 month, and 3 months after surgery with fundus fluorescein angiography (FFA) and aqueous sampling. Each sample was analysed for VEGF, HGF, Il-1 β (pg/ml), and PEDF (μg/ml) by sandwich ELISA.

Results: Clinically significant macular oedema (CSMO) occurred in one patient although increased macular hyperfluorescence occurred in three patients on FFA at 1 month. VEGF 165 concentration increased 1 day after surgery from a median baseline of 68 pg/ml (range 22–87 pg/ml) to 723 pg/ml (range 336–2071) at day 1. By 1 month it had decreased to 179 (range 66–811 pg/ml). HGF concentrations steadily increased over the month while IL-1 β and PEDF concentrations demonstrated an acute rise on day 1 after surgery and then IL-1β returned to baseline concentrations while PEDF decreased to below baseline.

Conclusion: These results confirm altered concentrations of angiogenic and antiangiogenic growth factors after cataract surgery, which may induce subclinical and clinical worsening of diabetic maculopathy.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF
    4. All versions of this article:
      1. bjo.2005.087403v1
      2. 90/6/697 most recent

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.