Published in:
01-08-2003 | Clinical Investigation
Influence of argon laser trabeculoplasty on transforming growth factor-beta 2 concentration and bleb scarring following trabeculectomy
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 8/2003
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Background
The purpose of this study was to evaluate the influence of previous argon laser trabeculoplasty (ALT) on transforming growth factor-beta 2 (TGF-beta 2) concentration of the aqueous humor and its influence on bleb scarring after trabeculectomy.
Methods
Fifty-one patients with primary open-angle glaucoma (POAG) and 29 patients with exfoliation (XFS) glaucoma were recruited for this prospective study before undergoing trabeculectomy. Sixty to 200 µl of aqueous humor were analyzed for total and biologically active TGF-beta 2 concentrations (R and D Systems). TGF-beta 2 levels and a standardized bleb assessment were compared between the ALT- and non-ALT-treated groups.
Results
POAG eyes without ALT showed significantly higher total TGF-beta 2 levels (2,317.7±1,041.1 pg/ml) than eyes with previous ALT (1,621.6±899.6 pg/ml; P=0.026). No significant difference was found for active TGF-beta 2 levels (ALT: 238.1±119.0 pg/ml; no ALT: 220.1±96.9 pg/ml; P=0.585). In XFS patients ALT did not alter total TGF-beta 2 levels (ALT: 1,524.9±624.9 pg/ml, no ALT: 1,220±499.1 pg/ml; P=0.20), but active TGF-beta 2 was significantly higher in the ALT-treated (237.0±99.7 pg/ml) than in the non-ALT-treated (140.0±95.3 pg/ml, P=0.028) group. Bleb grading revealed no statistical difference between the ALT- and non-ALT-treated groups in POAG (P=0.545, Fisher's exact test), whereas XFS patients with ALT were at increased risk for scarring compared to non-ALT-treated patients (P=0.053).
Conclusions
ALT appears to increase the risk of scarring in XFS patients because of increased levels of activated TGF-beta 2.