In Vivo Goblet Cell Density as a Potential Indicator of Glaucoma Filtration Surgery Outcome
In Vivo Goblet Cell Density as a Potential Indicator of Glaucoma Filtration Surgery Outcome
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DOI：
10.1167/iovs.16-19257
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发表时间：
2016-06-01
影响因子：
4.4
通讯作者：
Marchini, Giorgio
中科院分区：
文献类型：
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作者：
Agnifili, Luca;Fasanella, Vincenzo;Marchini, Giorgio
目的。方法采用激光扫描共聚焦显微镜(LSCM)和印迹细胞学(IC)对57例青光眼小梁切除术患者术前结膜杯状细胞密度(GCD)、MUC5AC和人类白细胞抗原-DR(HLADR)进行分析。在基线时，在计划的手术部位进行LSCM和IC；12个月后在滤过泡部位重复LSCM。结果：小梁切除术成功39例(完全成功27例，合格12例)，未成功18例(第3组)。第1~3组眼压(Mm Hg)分别为27.2+/-3.12、27.5+/-2.23和27.7+/-1.90，GCD和MUC5AC阳性率第1组高于第2组和第3组(P<；0.05)，HLADR、MMD和MMA组间差异无统计学意义。术后12个月，第1~3组眼压分别下降45.3%、35.4%和12.8%。1组杯状细胞密度无明显变化，2、3组杯状细胞密度降低(P<0.05)，3组杯状细胞密度降低(P<0.05)。1、2组平均微囊密度和MMA增加(P<0.05)，1组升高(P<0.05)。眼压下降与术后12个月眼压下降(P<；0.001，r=0.641)、平均眼压(P<；0.05，r=0.454)、平均眼压(P<；0.001，r=0.541)呈正相关。
PURPOSE. We analyzed the preoperative conjunctival goblet cell density (GCD), MUC5AC, and HLA-DR in glaucomatous patients undergoing trabeculectomy, using laser scanning confocal microscopy (LSCM) and impression cytology (IC).METHODS. We enrolled 57 patients undergoing trabeculectomy. At baseline LSCM and IC were performed at the site planned for surgery; LSCM was repeated after 12 months at the bleb site. The main outcomes were: GCD, mean microcyst density (MMD) and area (MMA) at LSCM, MUC5AC, and HLA-DR positivity at IC, and IOP The relationships between baseline GCD, and 12-month IOP, MMD, and MMA were analyzed.RESULTS. Trabeculectomy was successful in 39 patients (complete success in 27, Group 1; qualified in 12, Group 2), and unsuccessful in 18 (Group 3). At baseline IOP (mm Hg) was 27.2 +/- 3.12, 27.5 +/- 2.23, and 27.7 +/- 1.90 in Groups 1 to 3, respectively; GCD and MUC5AC positivity were higher in Group 1 compared to Groups 2 and 3 (P < 0.05); HLA-DR, MMD, and MMA were not significantly different among the groups. At 12 months, IOP reduced by 45.3%, 35.4%, and 12.8% in Groups 1 to 3, respectively. Goblet cell density did not change in Group 1, whereas it was reduced in Groups 2 and 3 (P < 0.05), with values lower in Group 3. Mean microcyst density and MMA increased in Groups 1 and 2 (P < 0.05), with values higher in Group 1 (P < 0.05). Baseline GCD positively correlated with 12-month IOP reduction (P < 0.001, r = 0.641), MMD (P < 0.05, r = 0.454), and MMA (P < 0.001, r = 0.541).CONCLUSIONS. Goblet cells positively affect the filtration ability after trabeculectomy; therefore, preoperative GCD could be considered as a potential in vivo biomarker of surgical success.