| Background and Purpose:In the field of cataract,We often encounter such a phenomenon: most patients complain that the second eye cataract surgery is more painful than the first eye.A recent study have found that there is a high expression of a cytokine which is monocyte chemotactic factor-1 in the second-eye aqueous humor after the first eye underwent cataract surgery,Analysis of the mechanism of pain increase in the second eyes cataract surgery from molecular level,is a hot research now.Monocyte chemotactic factor-1(MCP-1)which is considered to be a new member of the pain family is an important factor of pain and plays its biological activity with its specific receptor CCR2.Whether chemokines involved in pain is a new hot spot in the field of pain recently.Current research shows that a significantly increased MCP-1 molecule was detected in the contralateral aqueous humor after cataract surgery in the first eye.However,the trend of its expression has not been reported.This study uses enzyme linked immunosorbent assay(ELISA)to detect the concentration of MCP-1 in aqueous humor,and resolves the correlation analysis of the expression level of MCP-1 in the first-eye aqueous humor with the second-eye aqueous humor during different operative time section in the second eyes cataract surgery.The aim is to explore the tendency of the secretion of MCP-1 in aqueous humor of the second eye in patients with cataract by phacoemulsification after the first eye underwent cataract surgery.and to provide a theoretical basis for the optimal operation opportunity of another eye.Method:This experiment is conducted in the ophthalmic center of the second hospital of Jilin university from May to October 2016.Aqueous humor specimes are collected from 141 eyes of cases with cataract phacoemulsification combined with intraocular lens implantation in our hospital cataract department.Aqueous humor specimes collected from 20 eyes in first-eye Cataract phacoemulsification combined with intraocular lens implantation in our hospital cataract department is taken as control group.Aqueous humor specimes collected from 121 eyes in second-eye cataract phacoemulsification combined with intraocular lens implantation in our hospital cataract department is taken as research group.The time interval of binocular operation was 1 day,3 days,1 week,2 weeks,3 weeks,4 weeks,5 weeks and 6 weeks.In research group,the binocular operation time interval 1 day is recorded as research group 1,collected 15 eyes;the binocular operation time interval 3 days is recorded as research group 2,collected 15 eyes;the binocular operation time interval 1 week is recorded as research group 3,collected 15 eyes;the binocular operation time interval 2 weeks is recorded as research group 4,collected 14 eyes;the binocular operation time interval 3 weeks is recorded as research group 5,collected 15 eyes;the binocular operation time interval 4 weeks is recorded as research group 6,collected 16 eyes;the binocular operation time interval 5 weeks is recorded as research group 7,collected 15 eyes;the binocular operation time interval 6 weeks is recorded as research group 8,collected 16 eyes,respectively.All operations were performed by the same experienced physician,and the cataract phacoemulsification was completed by infinity ultrasound,produced by ALCON company,The selected cases were all age related cataract patients,excluding all uveitis,glaucoma,zonular weakness,eye operation history(including laser photocoagulation),diabetes-related disorders,retinal diseases and ocular history of injury,and no complications occurred during the operation of phacoemulsification.In this study,the concentration of MCP-1 in aqueous humor specimens was detected by enzyme linked immunosorbent assay(ELISA),and the expression level of of MCP-1 concentration in the control group and group of study groups are compared respectively.Finally,the patient information and experimental data are analyzed statistically.Results:(1)There are 20 eyes in the control group,male 9 cases,female 11 cases,right eye 14 eyes,left eye 6 eyes,age 42 ~ 81 years old,average age is 68.9 ±10.6 years old.There are 15 eyes in the research group 1 male 8 cases,female 7 cases,right eye 9 eyes,left eye 6 eyes,age 44 ~ 82 years old,average age is 64.6±10.5 years old.There are 15 eyes in the research group 2,male 5 cases,female 10 cases,right eye 7 eyes,left eye 8 eyes,age 45 ~ 86 years old,average age is 66.8±11.6 years old.There are 15 eyes in the research group 3,male 7 cases,female 8 cases,right eye 7 eyes,left eye 8 eyes,age 62 ~ 86 years old,average age is 73.2±7.2 years old.There are 14 eyes in the research group 4,male 10 cases,female 4 cases,right eye 7 eyes,left eye 7 eyes,age 60 ~ 82 years old,average age is 72.7±6.9 years old.There are 15 eyes in the research group 5,male 6 cases,female 9 cases,right eye 5 eyes,left eye 10 eyes,age 46 ~ 84 years old,average age is(70.7±9.5)years old.There are 16 eyes in the research group 6,male 8 cases,female 8 cases,right eye 8 eyes,left eye 8 eyes,age 60 ~ 83 years old,average age is 72.1±7.8 years old.There are 15 eyes in the research group 7,male 7 cases,female 8 cases,right eye 8 eyes,left eye 7 eyes,age 60 ~ 83 years old,average age is 72.8±7.1 years old.There are 16 eyes in the research group 8,male 8 cases,female 8 cases,right eye 11 eyes,left eye 5 eyes,age 56 ~ 85 years old,average age is 72.3±8.0 years old.(2)Compared with the control group,The concentration of MCP-1 in aqueous humor in the research group 1,research group 2,research group 3,research group 4,research group 5,research group 7 and research group 8 group did not increase significantly(all p > 0.05,t test);However,the concentration of MCP-1 in the aqueous humor in the research group 6 were significantly increased,with statistical significance(p < 0.001,t test).Conclusion:1.4 weeks after the first eye underwent cataract surgery,High expression of inflammatory molecules detected in aqueous humor in the contralateral eye is monocyte chemoattractant protein-1(MCP-1).The factor is the key factor of the delayed immune response.it is assumed that sympathetic uveitis does occurred in the contralateral eye after the first-eye cataract phacoemulsification.2.MCP-1 which is considered to be a new member of the pain family is an important factor leading to pain.It helps to analyze this symptom why patients complain that the second-eye cataract phacoemulsification is more painful than the first eye.3.4 weeks after the first eye underwent cataract surgery,high expression of MCP-1 was detected in aqueous humor in the contralateral eye.Therefore,when the second eye undergo cataract phacoemulsification,we should try to avoid the inflammatory factor storm period in aqueous humor. |
