Novel Biomarkers To Predict Anterior Capsular Fibrosis And Possible Therapeutic Intervention

This study aimed to identify biomarkers in aqueous samples and anterior capsules and analyze its contribution to the formation of anterior capsular fibrosis.

Narayana Nethralaya Superspecialty Eye Hospital

In this prospective clinical study, we recruited 96 cataract surgery patients, divided into two groups: 58 with fibrosed capsules and 38 with normal capsules, all aged 40-80 years. Pediatric cases were excluded. Pre-operative assessments included slit-lamp photography and AS-OCT. Pre-operative treatment comprised non-steroidal anti-inflammatory and antibiotic drops, with steroids avoided. During routine cataract surgery, aqueous humor samples were collected for biomarker analysis. Metabolites were extracted and analyzed using UPLC-MS/MS. Statistical analysis was performed using MetaboAnalyst v6.0.

Volcano plot fold change analysis revealed 4733 upregulated and 1863 downregulated metabolites in the aqueous humor of fibrosed capsules compared to normal capsules. PLS-DA plot demonstrated clear separation between aqueous humor samples of normal and fibrosed capsules. Discriminant metabolomic features were identified based on the Variable Importance in Projection (VIP) score. Top VIP score metabolites, including 3-Indolepropionic acid, Quipazine, Harmaline, Morphinan-3-ol, Bunitrolol, and Tacedinaline, were upregulated in control samples compared to fibrotic samples. These metabolites are implicated in anti-inflammatory and anti-fibrotic processes.

Fibrosis and inflammation modulating metabolites identified in this study could serve as potential biomarkers for anterior capsular fibrosis. This discovery provides a foundation for developing targeted therapeutic interventions to mitigate fibrosis following cataract surgery.