The -174G/C interleukin-6 promoter polymorphism influences the development of macular oedema following uncomplicated phacoemulsification surgery.
OBJECTIVE
To determine whether the functional -174 G/C interleukin-6 gene polymorphism is a risk factor for the development of cystoid macular oedema (CMO) following routine uncomplicated phacoemulsification surgery in patients with no established risk factors.


METHODS
A total of 40 patients who underwent routine phacoemulsification surgery as part of a randomised controlled trial comparing the use of postoperative steroid drops against a single sub-tenon injection of triamcinolone were genotyped for the IL-6 -174G/C polymorphism. All patients underwent fluorescein angiography at 30 days and anterior chamber flare measurements pre-operatively and at day 1, 7, and 30.


RESULTS
Angiographic CMO developed in 14 patients of the 40 studied. 9 out of the 14 patients carried the GG genotype (Fisher's exact test P=0.05, Hazard ratio for GG genotype; 4.05 (1.02-16.00)). There was no difference in flare measurements between the GG and Non-GG (GC/CC) group. The two groups were otherwise well matched in terms of age, sex, phacoemulsification energy used intraoperatively, and proportion of patients receiving postoperative triamcinolone or steroid drops.


CONCLUSIONS
The -174G/C interleukin-6 promoter gene variant appears to modulate the response to phacoemulsification surgery and to influence the development of postoperative CMO. These data suggest a genetic predisposition to this complication.
Masood
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I
Department of Ophthalmology, Queen's Medical Centre, Derby Road, Nottingham, UK. imranmasood777@hotmail.com
Negi
A
A
Vernon
S A
SA
Comeglio
P
P
Child
A H
AH
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D015850:Interleukin-6 / Q000235:genetics*; D008269:Macular Edema / Q000209:etiology / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011110:Polymorphism, Genetic; D011182:Postoperative Care / Q000379:methods; D011401:Promoter Regions, Genetic / Q000235:genetics; D012307:Risk Factors; D014221:Triamcinolone / Q000008:administration & dosage
D005938:Glucocorticoids; D015850:Interleukin-6; D014221:Triamcinolone