Evaluation of the Effects of Plasma-Assisted Noninvasive Surgery on the Concentration of Candidate Cytokines in Tear and Serum Samples of Conjunctivochalasis Patients

Purpose: The present study aimed to determine whether treating symptomatic Conjunctivochalasis (CCh) patients with Atmospheric Low-Temperature Plasma (ALTP) can stimulate inflammatory responses or not; if yes, are they in a stable state and how long do they take back to the normal range? Methods: In this study, 20 patients with definite CCh -with a grade of 3 and 4 -were recruited (identifier: IRCT20181229042160N3). ALTP was generated and used to undertake the surgery; the digital camera examinations were used to follow up the clinical outcomes after surgery. Tear and serum samples were isolated from each patient at 1 week, 1 month, and 3 months after treatment, and the concentration of candidate pro-inflammatory (i.e. IL-2, IL-6, IL-17A, IFN-γ, and TNF-α) and anti-inflammatory cytokines (IL-4 and IL-10) was measured using flow cytometry. Results: In all patients, grades 3 and 4 of CCh were substantially improved to grades 1 and 2, respectively; clinically, after one month, no complications were reported in the eyes that were subjected to ALTP-based surgical procedure. Besides, the analyses revealed that the ALTP-based treatment could improve the 'Ocular Surface Disease Index' score. Interestingly, regarding the concentration of the candidate cytokines in the tear and serum samples, no differences were observed at pre- and post-surgery follow-ups. Conclusion: In sum, we reintroduced using the Plasma-Assisted Noninvasive Surgery method as a novel approach to treat CCh because of its accurate handy nature with no stimulated inflammatory responses.