Investigation of the fibrotic effect in conjunctiva of the amount of MCP-1 SPARC and thrombospondin-2 molecules found in the humoral aqueous structures of primary open angle glaucoma patients who underwent glaucoma gel micro implant and phacoemulsification combined surgery on the time and number needling

Purpose: To investigate MCP-1, SPARC and TSP-2 proteins, which we think may cause subconjonctival fibrosis, surgical failure and need for bleb needling in POAG patients undergoing glaucoma gel microimplant. Materials and Methods: A total of 36 patients with primary open angle glaucoma who underwent phacoemulsification (Group 1) in 20 patients (6 female, 14 male, age: 68,5000 ± 8,87634); glaucoma gel microimplant and phacoemulsification combined surgery (Group 2) in 16 patients (9 female, 27 male, age: 66,1111 ± 8,52485) were included in the study. All patients were evaluated preoperatively and postoperatively by detailed eye examination, measurement of intraocular pressure, thickness of retina nerve fiber layer and ganglion cell complex. At the beginning of the operation, 50-200 μL of aqueous humor samples were taken from the limbal paracentesis site. We investigated the failure, bleb needling number and time of MCP-1, SPARC, TSP-2 after gel microimplant. We also investigated the safety and effectiveness of the gel microimplant. Results: A decrease in intraocular pressure (IOP) and antiglaucomatous medication was observed with gel microimplant (p<0.05). Postoperative complication rate was %31.25 and it improved with medication. Complete surgical success %60; partial surgical success %93; the bleb needling rate was %37.5 at the end of 6 months. The relation of IOP height on postoperative 1st day and 1st week with bleb needling was significant (p<0.05). Although there is no significant relationship between the number of bleb needles and MCP-1, SPARC, TSP-1; There was a significant correlation between the number of molecules used preoperatively (p<0.05). In addition, there was a significant correlation between pre and postoperatively RNFL and GCC values and SPARC and TSP-2 (p<0.05). Results: Our data to say that MCP-1, SPARC, and TSP-1 are associated with bleb needling and peritubular fibrosis are limited. However, in this study, it was concluded that chronic inflammation, increased POAG stage, the molecules we examined, especially SPARC increased. Key Words: Minimally invasive glaucoma surgery, primary open angle glaucoma, monocyte chemoattractant protein-1 (MCP-1), secreted protein acidic and rich in cysteine (SPARC), thrombospondin-2 (TSP-2).