目的：研究第一眼白内障手术是否会引起对侧眼炎症反应，并尝试探究该炎症反应的发展规律。

方法：本课题为配对样本实验，共纳入37例双眼年龄相关性白内障患者，实验样本均来源于患者术眼房水。其中行第一眼超声乳化白内障吸除联合人工晶状体植入术时收集的房水样本纳为A组(共37眼)，行第二眼超声乳化白内障吸除联合人工晶状体植入术时收集的房水样本纳为B组(共37眼)。并根据患者双眼白内障手术间隔时间将样本分为五组。最终，待所有样本收集完成，通过Luminex生物检测技术同时检测其中TNF-α，IL-6，IL-8，CCL2/MCP-1，IL-6 Rα，IL-1 ra，MIP-1α，MIP-1d，CCL4，IL-2，CXCL9，TIMP-1，CCL11等13种细胞因子的浓度。

结果：本研究所检测的13种细胞因子中，IL-6，MIP-1α，CCL2/MCP-1，TNF-α，MIP-1d，IL-2，TIMP-1等7种因子在双眼中的浓度有显著性差异(P<0.05)，且均表现为第二眼高于第一眼，其中第二眼房水中IL-6和 MIP-1α的浓度较第一眼呈显著性升高(P<0.001)。与第一眼相比，CCL4，CCL11，IL-6Rα，CXCL9，IL-1ra等炎症因子在第二眼中的浓度只有轻微升高，IL-8表现为轻微下降，差异均无统计学意义(P>0.05)。且研究结果提示，第一眼后3wk，IL-6，MCP-1/CCL2，IL-2，MIP-1d等4种炎症因子在双眼房水中的浓度差异最为显著。

结论：本研究提示超声乳化白内障吸除联合人工晶状体植入术可能引起对侧眼的免疫反应，且第二眼的免疫反应高峰期大约出现在第一眼术后3wk左右。

METHODS: In this paired-sample study, aqueous humor samples from 37 bilateral age-related cataract patients were collected just before each cataract surgery. Samples collected during the first-eye cataract surgery were marked as Group A, samples collected during the second-eye cataract surgery were marked as Group B. In addition, the samples were classified into five groups according to different operation intervals between the first and the second cataract surgery. Finally the concentration of 13 selected cytokines(including TNF-α, IL-6, IL-8, CCL2/MCP-1, IL-6 Rα, IL-1 ra, MIP-1α, MIP-1d, CCL4, IL-2, CXCL9, TIMP-1, CCL11)in aqueous humor samples was detected by Luminex-200(RnD)simultaneously in accordance with the manufacturer's instructions.

RESULTS: Among the 13 selected cytokines, there was statistically difference between the first and the second eyes in concentration of IL-6, MIP-1α, CCL2/MCP-1, TNF-α, MIP-1d, IL-2 and TIMP-1(P<0.05), and the expression levels of all these seven cytokines in the second eyes were higher than those in the first eyes, and the concentration of IL-6 and MIP-1α in the second eyes was significantly higher than that in the first eyes(P<0.001). Compared with the first eyes, the concentration of CCL4, CCL11, IL-6Rα, CXCL9, and IL-1ra in the second eyes only showed slightly increase, while IL-8 showed a slight decrease, all with no statistically difference(all P>0.05). The concentration differences of IL-6, MCP-1/CCL2, IL-2, MIP-1d between the first eyes and the second eyes were most obvious at the third week after phacoemulsification combined with intraocular lens implantation(PHACO+IOL)in the first eye.

CONCLUSION: This study revealed that there may be an inflammatory response in the contralateral eye after cataract surgery in the first eye, and the inflammatory response in the second eye appears to be most significant at the third week after phacoemulsification combined with intraocular lens implantation(PHACO+IOL)in the first eye.