Altered expression level of inflammation-related genes and long-term changes in ocular surface after trabeculectomy, a prospective cohort study

Abstract Purpose We aim to evaluate changes in the ocular surface in a cohort of post-trabeculectomy patients and whether these were associated with conjunctival inflammatory gene expression. Methods This is a single-arm interventional cohort performed in a tertiary referral center. These were assessed: dry eye symptom questionnaire, tear osmolarity, Schirmer's test, non-invasive tear break up time (BUT), conjunctival redness and corneal fluorescein staining evaluation. Conjunctival impressions were performed using Eyeprim, and after RNA extraction, transcripts of 255 inflammatory genes were analysed using the Nanostring nCounter assay. Results Thirty three patients were recruited with age 66.88 ± 9.76 at baseline, with a predominance of men. There was a significant decrease in inferior corneal staining at 6 months (p  Conclusions Glaucoma surgery may confer long term beneficial effect on the ocular surface, if anti-glaucoma eyedrops are no longer necessary. This may be due to reduced expression of conjunctival proinflammatory genes and immune-related genes.