Aqueous humor cytokine profiles in diabetic cataract: Linking glycemic status to surgical inflammatory risk

Abstract

Abstract: PURPOSE: Diabetic cataract patients with poor glycemic control are often ineligible for surgery due to higher risk of complications, such as delayed wound healing and infections, worsened by inflammation from the surgical procedure itself. This study aimed to evaluate the relationship between blood sugar level and pro-inflammatory mediators, providing valuable insights into the underlying mechanisms that contribute to these risks. MATERIALS AND METHODS: Aqueous humor samples were collected from 33 diabetic cataract patients and 33 senile cataract patients during phacoemulsification surgery. Spearman’s correlation analysis was conducted to determine the relationship between Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels in aqueous humor with random blood glucose (RBG) and Hemoglobin A1c (HbA1c) levels. RESULTS: IL-6 levels were significantly higher in diabetic patients compared to the control group (17.83 ± 13.66 vs. 9.40 ± 3.83; P < 0.01), whereas TNF-α levels showed no significant difference (15.47 ± 1.58 vs. 16.91 ± 3.71; P = 0.145). The analysis revealed no significant relationship between IL-6 levels in aqueous humor and RBG ( P = 0.069) or HbA1c ( P = 0.131). However, TNF-α levels in the aqueous humor showed a weak but statistically significant correlation with RBG ( P = 0.034, ρ = 0.262), whereas no significant association was observed with HbA1c ( P = 0.853). CONCLUSIONS: Acute perioperative glycemic status, reflected by RBG levels, was associated with intraocular TNF-α concentrations, suggesting a relationship between short-term hyperglycemia and local inflammatory activity. Elevated IL-6 levels in diabetic patients appeared to reflect chronic inflammatory changes rather than acute glucose fluctuations. Optimization of perioperative glycemic control, together with appropriate anti-inflammatory strategies, may help reduce intraocular inflammation in diabetic patients undergoing cataract surgery.

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