Monocyte chemotactic protein-1 level in the aqueous humour as a prognostic factor for the outcome of trabeculectomy

Background The aim of this study was to elucidate the effects of the aqueous humour monocyte chemotactic protein-1 level on the surgical outcome of trabeculectomy in cases of phakic glaucoma. Design Retrospective study. Participants Fifty-three cases of open-angle glaucoma. Methods At the time of trabeculectomy, aqueous humour samples were collected before any incisions were made. The monocyte chemotactic protein-1 level was then determined by immunoassay. The Cox proportional hazards test was used to analyse the clinical factors related to failure of trabeculectomy. Subsequently, the success probability was calculated by Kaplan-Meier analysis and cumulative success probabilities were analysed by the log-rank test. Main Outcome Measures Probability of success. Results In 30 phakic glaucoma and 23 pseudophakic glaucoma cases, the mean monocyte chemotactic protein-1 levels in aqueous humour were 1165.2 and 2152.9pg/mL, respectively; the difference was statistically significant (P<0.0001). Univariate analysis showed that the outcomes of surgery were correlated with the monocyte chemotactic protein-1 level, but not with age, gender, diagnosis of exfoliation glaucoma, pseudophakic status or pretrabeculectomy intraocular pressure. Subsequent multivariate analysis revealed that only the aqueous humour monocyte chemotactic protein-1 level was significantly correlated with the outcomes of trabeculectomy (P=0.043). Among the 30 phakic glaucoma eyes, the success probabilities after trabeculectomy were significantly different between the high and low monocyte chemotactic protein-1 groups (P=0.018). Conclusion In open-angle glaucoma patients, the monocyte chemotactic protein-1 level is a prognostic factor for the results of trabeculectomy.