The Protective Effect of Metformin Use on Early Nd:YAG Laser Capsulotomy
| Autor: | Michelle G. Pedler, Carson C. Petrash, Brandie D. Wagner, Alan G. Palestine, Biehuoy Shieh, Anne M. Lynch, Karen L Christopher, Jennifer L. Patnaik, Naresh Mandava, J. Mark Petrash |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors genetic structures posterior capsule opacification medicine.medical_treatment Context (language use) Lasers Solid-State Postoperative Complications Ophthalmology Diabetes mellitus medicine Humans Hypoglycemic Agents Aged Retrospective Studies Lenses Intraocular Univariate analysis business.industry Posterior Capsulotomy Clinical and Epidemiologic Research Hazard ratio Phacoemulsification cataract surgery Capsule Opacification Middle Aged medicine.disease eye diseases Metformin Treatment Outcome YAG Nd:YAG laser Capsulotomy Posterior Capsule of the Lens Female Laser Therapy business medicine.drug Follow-Up Studies |
| Zdroj: | Investigative Ophthalmology & Visual Science |
| ISSN: | 1552-5783 |
| Popis: | Purpose To determine the effect of metformin on early Nd:YAG laser treatment for posterior capsule opacification (PCO) and to explore a molecular mechanism to explain a possible protective effect of metformin against PCO. Methods We conducted: 1) a retrospective cohort study of patient eyes undergoing phacoemulsification at our institution; and 2) laboratory investigation of the effect of metformin on the behavior of lens epithelial cells in the context of an animal model for PCO. Population-averaged Cox proportional hazards modeling was used to estimate risk for time to Nd:YAG. For laboratory studies, expression of markers for epithelial-to-mesenchymal transition (EMT) implicated in PCO pathogenesis was measured in tissue culture and following extracapsular lens extraction in a mouse model. Results The rate of Nd:YAG laser capsulotomy was 13.1% among the 9798 eyes. Both metformin use and diabetes were protective factors for Nd:YAG laser capsulotomy in univariate analysis. However, in multivariable analysis with nondiabetics as the reference group, only metformin use among diabetics was significantly protective of Nd:YAG (hazard ratio: 0.68, 95% CI: 0.54-0.85, P = 0.0008), while eyes of patients with diabetes without metformin use did not significantly differ (P = 0.5026). Treatment of lens epithelial cells with metformin reduced the level of the EMT markers ⍺-SMA and pERK induced by TGF-β2. Similarly, metformin treatment reduced ⍺-SMA expression in lens epithelial cells following extracapsular lens extraction in a mouse model. Conclusions The protective effect of metformin against early Nd:YAG may relate to its ability to downregulate EMT in residual lens epithelial cells that otherwise trend toward myofibroblast development and PCO. |
| Databáze: | OpenAIRE |
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