Preliminary report: Malondialdehyde alteration and total antioxidant capacity levels in senile and complex cataract patients

This study aims to measure oxidative stress levels in cataract patients with varying causes. Total antioxidant capacity (TAC) and malondialdehyde (MDA) levels in the aqueous humor are biomarkers of oxidative stress in the eye, in which ocular comorbidities and systemic conditions will influence preexisting oxidative stress, as will the phacoemulsification surgery performed. Consequently, this study investigates the changes in MDA levels after phacoemulsification and clinical manifestations of the corneal endothelial layer after surgery. Samples from 34 subjects were collected using a consecutive sampling approach. Ethical approval was obtained from the Ethics Committee of Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, University of Indonesia (Approval No. KET-1156/UN2.F1/ETIK/PPM.00.02/2024). Aqueous humor samples were collected during and after phacoemulsification to measure MDA and TAC levels. Biomarker results were analyzed using SPSS ver. 25. A total of 34 cataract patients with various conditions were analyzed. Prephacoemulsification MDA levels were found to be not significantly different among groups categorized by nuclear density and prior surgery status. Postphacoemulsification MDA level is 58.38 ng/mL, lower insignificantly compared to pre-MDA level. However, in the postoperative analysis, MDA levels were found to have no significant correlation between cumulative dissipated energy and endothelial cell density loss ( P = 0.723 and P = 0.676). Biomarker levels can vary widely among cataract cases, reflecting heterogeneous oxidative stress responses. These short-term preliminary findings suggest that surgical parameters or early endothelial outcomes may not directly predict oxidative stress responses in the aqueous humor.