Multiplex Cytokine Profiling: Comparison Between Low-Energy Femtosecond Laser-Assisted Cataract Surgery And Conventional Phacoemulsification

To compare the multiplex cytokine profile in the aqueous humor of patients undergoing Femtosecond laser-assisted cataract surgery (FLACS) using a low-energy device and conventional phacoemulsification procedures.

Single-center prospective biomarker study

This study was conducted on 82 eyes of 82 patients undergoing FLACS compared to an age- and sex matched group (1:4) of 328 patients undergoing manual small incision phacoemulsification surgery. We collected aqueous humor samples immediately after laser application for capsulotomy and lens fragmentation using a low-energy laser system (FEMTO LDV Z8, Ziemer Ophtalmic Systems AG, Port, Switzerland) in the FLACS group or immediately after incision prior to phacoemulsification in the conventional phacoemulsification group. We measured cytokine levels of 11 different proteins using a multiplex cytokine assay (Ayoxxa Biosystems, Cologne, Germany). Patient characteristics were obtained from clinical records.

Patients undergoing FLACS had significantly lower median levels of Angiopoietin-2 (64 vs 145 pg/ml, p =0.031), Chemokine ligand CXCL13 (8 vs 22 pg/ml, p<0.001), Interleukin-6 (2 vs 4 pg/ml, p=0.001), Interleukin-8 (3.1 vs 3.8 pg/ml, p=0.038), Platelet Derived Growth Factor-BB (2 vs 7 pg/ml, p<0.001), Placental Growth Factor (6 vs 17 pg/ml, p<0.001) or Vascular Endothelial Growth Factor-A (261 vs 286 pg/ml, p=0.032). We observed no difference for median levels of CCL2 (p=0.8), C-reactive Protein (p=0.71), CXCL10 (p=0.17) or CXCL12 (p=0.88). 

The findings suggest reduced inflammation cytokine profiles in the FLACS group using a low-energy laser system. Further investigation is warranted as previous studies reported higher levels of cytokines, such as IL-6, in patients undergoing FLACS.