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Trefoil factor family 1, MUC5AC and human leucocyte antigen-DR expression by conjunctival cells in patients with glaucoma treated with chronic drugs: could these markers predict the success of glaucoma surgery?

¹ Department of Ophthalmology, University Hospital, Dijon, France
² INSERM U 517, University Hospital
³ Centre Hospitalier National d’Ophtalmologie des Quinze Vingts, Paris, France

Correspondence to:
Correspondence to:
A M Bron
Service d’Ophtalmologie, Hôpital Général, 21000 Dijon, France;alain.bron{at}chu-dijon.fr

Aims: To evaluate conjunctival expression of trefoil factor family (TFF)1, MUC5AC and human leucocyte antigen (HLA)-DR in patients with glaucoma treated with topical drugs, and to determine whether these parameters can predict the outcome of glaucoma surgery.

Methods: 77 conjunctival impression cytology specimens were collected from 77 patients with glaucoma (66 receiving drops with preservative and 11 treated with preservative-free drops) and 43 controls. TFF1, MUC5AC and HLA-DR expression was analysed using flow cytometry. Trabeculectomy was performed in 56 patients; success was defined as an intraocular pressure (IOP) 15 mm Hg without any IOP-lowering drug at 6 months.

Results: The expression of TFF1, MUC5AC and HLA-DR was significantly higher in patients than in controls (p = 0.01, 0.05 and 0.004, respectively). A higher expression of MUC5AC was found in patients treated with preserved drops than in those receiving unpreserved drops (p = 0.04). A higher MUC5AC expression and a lower HLA-DR expression was observed in successful glaucoma surgeries than in failures.

Conclusions: TFF1 and MUC5AC secretions are probably a response to mild ocular surface changes caused by long-term use of topical treatment. Their increased expression could be a predicting factor of further successful glaucoma surgery.

Abbreviations: HLA, human leucocyte antigen; IOP, intraocular pressure; PBS, phosphate-buffered saline; TTF, trefoil factor family