Surgery increases risk of conjunctival scars

A greater number of mast cells are present in the conjunctiva of glaucoma patients who have undergone ocular surgery, possibly leading to increased scarring, according to study results published online ahead of print by Eye.

Lydia Chang of the Paediatric Glaucoma Service at Moorfields Eye Hospital, London, UK and colleagues identified the presence of tryptase, the intracellular mast cell enzyme, in the conjunctiva of glaucoma patients treated medically (n=6), with repeated surgery (n=8) and for uveitic glaucoma (n=7). They compared the tryptase levels with those found in the conjunctival biopsies of the control group (retinal detachment patients, n=8).

The median tryptase level of the control group was 0.064 cells/mm²; among the glaucoma groups, the median level ranged from 0.102 cells/mm² to 0.113 cells/mm². There was a statistically significant difference between the tryptase level of the surgery glaucoma group when compared with control, although this statistically significant difference did not exist between the control group and either of the other glaucoma groups.

Because the tryptase levels were higher in glaucoma patients who had previously undergone surgery, the researchers concluded that the activity of mast cells may contribute to post-trabeculectomy conjunctival scarring.