Preoperative Aqueous Cytokine Levels Are Associated With a Rapid Reduction in Endothelial Cells After Penetrating Keratoplasty

Purpose To evaluate the influence of preoperative inflammatory cytokine levels in the aqueous humor (AqH) on the endothelial cell density (ECD) after penetrating keratoplasty (PKP). Design Prospective, interventional, consecutive case series. Methods This study includes 70 consecutive patients (mean age 73.7 ± 10.6 years) who underwent PKP (37 eyes) or cataract surgery (controls, 33 eyes). A total of 70 AqH samples were collected at the beginning of each surgery. The levels of cytokines (interleukin [IL]-1α, IL-1β, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, interferon [IFN]-α, IFN-γ, monocyte chemotactic protein [MCP]-1, E-selectin and P-selectin) in AqH were measured by multiplex bead immunoassay. The subjects who underwent PKP were classified into 2 groups: ECD ≥ 1200 cells/mm² at 6 months (24 eyes), and ECD < 1200 cells/mm² at 6 months (13 eyes). Results The ECD at 3 months significantly correlated with the preoperative levels of IL-10 (r = −0.428, P =.02) and IFN-γ (r = −0.412, P =.029). The ECD at 6 months significantly correlated with the preoperative levels of IL-10 (r = −0.399, P =.024), MCP-1 (r = −0.444, P =.011), and IFN-γ (r = −0.474, P =.006). The preoperative levels of IL-6, IL-10, MCP-1, IFN-γ, and P-selectin in AqH were significantly higher in eyes with ECD < 1200 cells/mm² compared with those with ECD ≥ 1200 cells/mm² at 6 months (P <.05). Conclusions Higher preoperative levels of IL-10, MCP-1, and IFN-γ in the AqH were associated with low ECD after PKP.