The effect of microcatheter-assisted circumferential trabeculotomy on aqueous humor cytokine and long-term intraocular pressure control in medically uncontrolled Posner-Schlossman syndrome patients: a 12-month prospective study

This study aims to investigate the effect of microcatheter-assisted trabeculotomy (MAT) on aqueous humor cytokine change and long-term intraocular pressure (IOP) control in medically uncontrolled Posner-Schlossman Syndrome patients. Prospective study. Demographic and clinical data were collected for medically uncontrolled PSS patients who underwent MAT from August 2022 to August 2024 in Peking University Third Hospital. All patients completed at least 12 months follow-up. Surgical success was defined as IOP maintained between 6 and 21 mmHg without antiglaucoma medications for complete success and with antiglaucoma medications for qualified success. Cytomegalovirus (CMV) DNA in aqueous humor was detected using real-time polymerase chain reaction. Aqueous humor levels of ICAM-1, IL-6, IL-8, IP-10, IL-10, CXCL9, G-CSF, VCAM-1, and CCL2 were quantified preoperatively and 1 week postoperatively. Protein-protein interaction and pathway enrichment analyses were performed to explore related inflammatory networks. Twelve eyes of 12 patients were enrolled. The IOP decreased from 32.8 ± 8.2 mmHg preoperatively to 14.1 ± 3.4 mmHg at 12 months postoperatively ( p < 0.001). The complete surgical success rate was 58.3% and the overall success rate at 12 months was 91.7%. The positive rate for CMV is 42% (5/12). ICAM-1, IL-6, IL-10, G-CSF, VCAM-1 and CCL2 elevated after MAT ( p = 0.002, 0.005, 0.028, 0.008, 0.002 and 0.003, respectively). Bioinformatics analysis revealed enrichment of terms related to chemokine-mediated signaling, cytokine-cytokine receptor interaction and viral protein-cytokine receptor interaction pathways. Although aqueous humor cytokine changes indicated early postoperative elevations of chemokine and virus-related inflammatory pathways, MAT might be an effective and safe surgical option for medically uncontrolled PSS patients. Not applicable.