The Effect of Combined Phacovitrectomy on Aqueous Humor Cytokines in Patients with Proliferative Diabetic Retinopathy
10.21561/jor.2025.10.2.232
- Author:
Hyo Sun YU
1
;
Yong Un SHIN
;
Sunjin HWANG
Author Information
1. Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
- Publication Type:ORIGINAL ARTICLE
- From:
Journal of Retina
2025;10(2):232-239
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:To investigate the impact of combined phacovitrectomy versus vitrectomy alone on perioperative concentrations of vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) in the aqueous humor (AH) of patients with proliferative diabetic retinopathy (PDR).
Methods:This prospective, comparative case series included 15 patients with PDR indicated for vitreoretinal surgery. AH samples were collected at three time points: preoperatively (one week prior to surgery), intraoperatively, and postoperatively (one month after surgery).Twelve patients underwent phacovitrectomy, and three patients underwent vitrectomy alone. All patients received a preoperative intravitreal bevacizumab injection. Concentrations of VEGF and IL-8 were quantified using enzyme-linked immunosorbent assay.
Results:In the overall cohort, AH VEGF concentrations followed a U-shaped pattern, decreasing from a preoperative mean of 322.26 pg/ mL to an intraoperative mean of 45.47 pg/mL (p = 0.002) before significantly rebounding to 205.16 pg/mL postoperatively (p = 0.005 vs.intraoperative). This trend was driven by the phacovitrectomy group, which showed a significant postoperative VEGF rebound (p = 0.002).Conversely, the vitrectomy-only group showed no significant change. IL-8 concentrations increased significantly from the intraoperative to the postoperative period in the phacovitrectomy group (p = 0.003), a change not observed in the vitrectomy-only group.
Conclusions:Phacovitrectomy induces a significant postoperative elevation of both VEGF and IL-8 in the anterior chamber, creating a pro-angiogenic and pro-inflammatory microenvironment. These findings provide a potential mechanistic explanation for increased risk of neovascular glaucoma observed clinically following combined phacovitrectomy.
