백내장수술 후 눈물 내 기질 금속단백분해효소 9 및 안구 표면불편감의 단기 변화
Short-term Changes in the Tear Matrix Metalloproteinase 9 Level and Ocular Surface Discomfort after Cataract Surgery
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
목적: 백내장수술 후 눈물 내 기질 금속단백분해효소 9 (matrix metalloproteinase 9, MMP-9)를 비롯한 건성안 임상 지표의 단기 변화를 확인하고 안구 표면 불편감 변화와의 상관성을 분석하였다. 대상과 방법: 백내장수술 환자 106명(106안)을 대상으로 수술 전, 술 후 1주, 1개월째 마이봄샘 기능장애, 눈물 분비량, 각막지각, 눈물막파괴시간, 각막미란, 안구표면염색지수, 눈물 내 삼투압, MMP-9 등급 및 안구표면질환지수(ocular surface disease index, OSDI)를 측정했다. 모든 환자는 술 후 1개월간 국소 목시플록사신 항생제, 스테로이드 및 비스테로이드 항염증제를 점안하였다. OSDI 점수의 1개월째 변화값과 건성안 지표들의 1개월째 변화값 간 상관성을 분석하였고, 술 후 1개월째 MMP-9 감소군과 MMP-9 비감소군 간 수술 전후 건성안 지표 변화값들의 차이를 분석하였다. 결과: 대상자의 89.5%에서 수술 전 건성안이 있었다. 눈물 내 MMP-9는 술 후 1개월째 감소하였고, 쉬르머 I 검사상 눈물 분비량은 1주째 감소하였으며, OSDI 점수는 1주째, 1개월째 모두 술 전 대비 감소하였다. 수술 전후 1개월째 OSDI 변화값은 모든 건성안 지표들의 수술 전후 변화값과 유의한 상관관계를 보이지 않았다. 술 후 1개월째 OSDI 점수는 MMP-9 감소군에서 MMP-9 비감소군 대비 유의하게 더 많이 감소하였다. 결론: 백내장수술 후 통상적으로 시행하는 국소 항염증 치료하에서 술 후 단기간 내 눈물 내 MMP-9 발현이 감소할 수 있으며 이는 안구 표면의 불편감 증상 완화와 연관될 수 있다.
Abstract
Purpose: We explored changes in the various clinical parameters of dry eye disease (DED), including the tear matrix metalloproteinase9 (MMP-9) level, soon after cataract surgery. We sought correlations between such changes and ocular surfacediscomfort. Methods: In 106 patients (106 eyes) who underwent cataract surgery, we evaluated meibomian gland dysfunction, tear secretion,corneal sensitivity, tear break-up time, corneal erosion status, the Sjögren’s International Collaborative Clinical Alliance(SICCA) ocular staining score, tear osmolarity, the tear MMP-9 level, and the ocular surface disease index (OSDI) before, and1 week and 1 month after surgery. All eyes were instilled with topical moxifloxacin, a steroid, and a non-steroidal anti-inflammatorydrug daily for 1 month postoperatively. The 1-month delta OSDI scores correlated with the 1-month delta DEDparameters. We compared the latter parameters between patients in whom the MMP-9 level decreased (MMP-9-decreasedgroup) at 1 month with those in whom it did not (MMP-9-not decreased group). Results: Overall, 89.5% of total patients exhibited preoperative DED. The tear MMP-9 level fell at 1 month postoperatively, tearsecretion (evaluated using the Schirmer I test) decreased at 1 week, and the OSDI scores fell at both 1 week and 1 month. Wefound no significant correlation between the 1-month delta OSDI scores and the 1-month delta DED parameters. The 1-monthOSDI score fell to a significantly greater extent in the MMP-9-decreased group. Conclusions: Routine, local anti-inflammatory treatment after cataract surgery may briefly reduce the tear MMP-9 level and ocularsurface discomfort.
참고문헌 (38)
- Kohlhaas M, "Corneal sensation after cataract and refractive surgery", J Cataract Refract Surg, 24, pp.1399~1409 (1998)
- 조양경, "Dry Eye After Cataract Surgeryand Associated Intraoperative Risk Factors", Korean Journal of Ophthalmology, 23(2), pp.65~73 (2009), 대한안과학회
- Bron AJ, "TFOS DEWS II pathophysiology report", Ocul Surf, 15, pp.438~510 (2017)
- Craig JP, "TFOS DEWS II report executive summary", Ocul Surf, 15, pp.802~812 (2017)
- Vehof J, "Prevalence and risk factors of dry eye disease in a British female cohort", Br J Ophthalmol, 98, pp.1712~1717 (2014)
- Jiang D, "Transient tear film dysfunction after cataract surgery in diabetic patients", PLoS One, 11, pp.e0146752~ (2016)
- Li XM, "Investigation of dry eye disease and analysis of the pathogenic factors in patients after cataract surgery", Cornea, 26(9 Suppl 1), pp.S16~S20 (2007)
- Ridder WH, 3rd, "Effect of povidone iodine 5% on the cornea, vision, and subjective comfort", Optom Vis Sci, 94, pp.732~741 (2017)
- Moon H, "Short-term influence of aspirating speculum use on dry eye after cataract surgery : a prospective study", Cornea, 33, pp.373~375 (2014)
- Hwang HB, "Phototoxic effects of an operating microscope on the ocular surface and tear film", Cornea, 33, pp.82~90 (2014)
- Nwaji E, "The effect of local anesthetics on tear production", JNOA, 12, pp.27~29 (2005)
- Simone JN, "Effects of anti-inflammatory drugs following cataract extraction", Curr Opin Ophthalmol, 12, pp.63~67 (2001)
- Al-Aqaba MA, "Architecture and distribution of human corneal nerves", Br J Ophthalmol, 94, pp.784~789 (2010)
- Xu KP, "Decrease in corneal sensitivity and change in tear function in dry eye", Cornea, 15, pp.235~239 (1996)
- Belmonte C, "Neural basis of sensation in intact and injured corneas", Exp Eye Res, 78, pp.513~525 (2004)
- Shimabukuro M, "Effects of cataract surgery on symptoms and findings of dry eye in subjects with and without preexisting dry eye", Jpn J Ophthalmol, 64, pp.429~436 (2020)
- Li DQ, "JNK and ERK MAP kinases mediate induction of IL-1beta, TNF-alpha and IL-8 following hyperosmolar stress in human limbal epithelial cells", Exp Eye Res, 82, pp.588~596 (2006)
- Li DQ, "Regulation of MMP-9production by human corneal epithelial cells", Exp Eye Res, 73, pp.449~459 (2001)
- Chiu PS, "Matrix metalloproteinase-9 leads to claudin-5degradation via the NF-kappaB pathway in BALB", c mice with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis, 2013, pp.8, e53370~
- Pflugfelder SC, "Matrix metalloproteinase-9knockout confers resistance to corneal epithelial barrier disruption in experimental dry eye", Am J Pathol, 166, pp.61~71 (2005)
- Messmer EM, "Matrix metalloproteinase 9 testing in dry eye disease using a commercially available point-of-care immunoassay", Ophthalmology, 123, pp.2300~2308 (2016)
- Miller KL, "Minimal clinically important difference for the ocular surface disease index", Arch Ophthalmol, 128, pp.94~101 (2010)
- Pflugfelder SC, "Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation", Cornea, 17, pp.38~56 (1998)
- Tomlinson A, "The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee", Invest Ophthalmol Vis Sci, 52, pp.2006~2049 (2011)
- Lemp MA, "Report of the national eye institute", industry workshop on clinical trials in dry eyes, 1995, pp.21, 221~232
- Whitcher JP, "A simplified quantitative method for assessing keratoconjunctivitis sicca from the Sjögren's Syndrome International Registry", Am J Ophthalmol, 149, pp.405~415 (2010)
- Park JY, "Matrix metalloproteinase 9point-of-care immunoassay result predicts response to topical cyclosporine treatment in dry eye disease", Transl Vis Sci Technol, 7, pp.31~ (2018)
- Wolffsohn JS, "TFOS DEWS II diagnostic methodology report", Ocul Surf, 15, pp.539~574 (2017)
- 김해랑, "눈물 내 기질 금속단백분해효소 9 농도에 따른 건성안의 임상양상 비교", 대한안과학회지, 60(12), pp.1140~1147 (2019), 대한안과학회
- Chotikavanich S, "Production and activity of matrix metalloproteinase-9 on the ocular surface increase in dysfunctional tear syndrome", Invest Ophthalmol Vis Sci, 50, pp.3203~3209 (2009)
- Bang SP, "In vitro validation of the tear matrix metalloproteinase 9 in-situ immunoassay", Sci Rep, 10, pp.15126~ (2020)
- Jun JH, "Importance of tear volume for positivity of tear matrix metalloproteinase-9 immunoassay", PLoS One, 15, pp.e0235408~ (2020)
- Huh J, "Changes in the matrix metalloproteinase 9 point-of-care test positivity according to MMP-9concentration and loading volume", Cornea, 39, pp.234~236 (2020)
- Ibrahim OM, "Application of visante optical coherence tomography tear meniscus height measurement in the diagnosis of dry eye disease", Ophthalmology, 117, pp.1923~1929 (2010)
- Nguyen P, "Correlation between optical coherence tomography-derived assessments of lower tear meniscus parameters and clinical features of dry eye disease", Cornea, 31, pp.680~685 (2012)
- 임찬영, "백내장수술 시 이측과 상측 투명각막절개후의 각막지각비교", 대한안과학회지, 45(10), pp.7~7 (2004), 대한안과학회
- 김용민, "백내장 수술 후 각막 지각의 변화와 각막신경 회복의 비교", 대한안과학회지, 48(1), pp.13~18 (2007), 대한안과학회
- Lee HK, "Bilateral effect of the unilateral corneal nerve cut on both ocular surface and lacrimal gland", Invest Ophthalmol Vis Sci, 60, pp.430~441 (2019)