Multiple inflammatory factors in aqueous humor are indicated to be correlated with postoperative macular edema (ME) in type 2 diabetic patients who received phacoemulsification (Phcao) cataract surgery. To analyze the correlation of aqueous inflammatory factors and cytokines with postoperative ME in these patients is significant for the treatment.

This study was to ascertain whether cytokines in the aqueous humor can predict ME in type 2 diabetic patients following Phaco cataract surgery.

One hundred and thirty-six eyes of 136 consecutive patients with type 2 diabetes were included from January 2010 to April 2012 in Tianjin Eye Hospital. All the patients received Phaco cataract surgery and 0.1 ml aqueous fluid was collected from each eye during the surgery under the informed consent. Twenty-seven cytokines in aqueous humor samples were simultaneously assayed using multiplex bead immunoassay. Central foveal thickness was measured using OCT before and after surgery, and ME was defined as an 30% increase in foveal thickness after operation. The correlations of 27 aqueous cytokines with ME were analyzed.

Phaco surgery was successfully performed in all the eyes, and 116 eyes completed the follow-up with the finishing rate 85.29%. ME occurred in 29.31% eyes (34/116) 4 weeks after surgery and were assigned to the ME (+) group; while 70.69% eyes (82/116) did not appear ME as the ME (-) group. The patients showed the matched demography between the two groups (all at P>0.05). The mean macular thickness value was (237.24±24.16) μm in the ME (+) group 4 weeks after operation, which was significantly higher than (162.41±21.33) μm before operation and (185.53±18.35) um in the ME (-) group (both at P<0.001). Compared to the ME(-) group, the concentrations of interleukin-1β (IL-1β), IL-6, IL-8, interferon-induced protein-10 (IP-10), monocyte chemotactic protein-1 (MCP-1) and vascular endothelial growth factor (VEGF) in aqueous of the ME (+) patients were significantly elevated (all at P<0.01). In addition, these factors showed positive correlation with the postoperative central foveal thickness (r=0.288, P=0.005; r=0.345, P=0.008; r=0.256, P=0.016; r=0.377, P=0.007; r=0.423, P=0.001; r=0.279, P=0.012) . However, the aqueous levels of IL-10 and IL-12 before operation were significantly lower in the ME(+) group compared with the ME(-) group (P=0.003, 0.017), and showed negatively correlated with the postoperative central foveal thickness (r=-0.327, P=0.013; r=-0.264, P=0.036). Logistic regression analysis showed that higher glycosylated hemoglobin and above mentioned factors were risk factors of ME following Phaco cataract surgery (OR=1.25, P=0.026; OR=1.31, P=0.006; OR=3.62, P<0.001; OR=1.82, P=0.007; OR=1.58, P<0.001; OR=4.21, P<0.001; OR=5.36, P<0.001; OR=0.19, P=0.011; OR=0.31, P=0.013).

The increases of aqueous IL-1β, IL-6, IL-8, IP-10, MCP-1, VEGF and decreases of IL-10, IL-12 are associated with postoperative ME in type 2 diabetic patients following Phaco cataract surgery.

Diabetes/complication; Retinopathy; Cytokine; Macular edema; Aqueous humor; Risk factors; Humans