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High VEGF levels in Tenon tissue linked to poor surgical outcomes in POAG patients
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High levels of anti-VEGF in Tenon tissue at the time of glaucoma surgery correlated strongly with failed surgery and elevated final IOP, a study found.
“Considering the wound-healing process, we should keep in mind the importance of the VEGF in Tenon tissue, where the wound healing process occurs,” the study authors said. “Tenon fibroblasts are the main effector cells in the initiation and mediation of wound healing and fibrotic scar formation after glaucoma surgery.”
The study included 19 patients who underwent surgery for primary open-angle glaucoma (POAG); 14 patients underwent trabeculectomy and five underwent Ahmed glaucoma valve implantation. A control group comprised 17 patients who underwent cataract surgery.
Inclusion criteria were IOP higher than 21 mm Hg, visual field or optic disc changes, and adherence to a maximum glaucoma medication dosage.
About 0.1 mL of aqueous humor and a 4-mm by 4-mm Tenon tissue sample were obtained from each patient at the time of surgery.
Study results showed that VEGF levels in Tenon tissue and aqueous humor were significantly higher in patients with POAG than in controls (P = .001). VEGF levels were also significantly higher in the Tenon tissue of patients whose surgery failed than in patients whose surgery succeeded (P = .014).
Final IOP was 14.85 mm Hg in patients with successful surgery and 23.2 mm Hg in patients with failed surgery; the between-group difference was statistically significant (P < .001).
The relationship between VEGF levels in the aqueous humor and final IOP was statistically insignificant, the authors said.
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