Evaluating lymphocyte-mediated systemic inflammation in patients requiring surgery for pterygium

PURPOSE: This study aims to evaluate lymphocyte-mediated systemic inflammation by analyzing the level of lymphocyte-to-monocyte ratio (LMR) and other hematological parameters in patients who underwent pterygium surgery.
METHODS: A retrospective, cross-sectional comparative study. Thirty-five patients underwent pterygium surgery, and 37 age- and sex-matched healthy controls were included. Pre-operative complete blood count parameters of all participants were analyzed. LMR, neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) levels were compared.
RESULTS: The mean age was 56.03±12.11 years in the patient group and 59.84±6.83 years in the control group. The lymphocyte count (LY) (p=0.009) and LMR were significantly higher in the pterygium group (p<0.001). No statistically significant differences were observed in the other hematological parameters between the groups (p>0.05). The ROC curve analysis demonstrated that LMR was a more reliable indicator of pterygium than NLR and SII. The AUC was 0.781 for LMR (95% CI, 0.673–0.888; p<0.001), was 0.424 (95% CI, 0.291–0.557; p=0.267), and 0.443 (95% CI, 0.309–0.577; p=0.408) for NLR and SII, respectively. The optimal cutoff value of LMR to predict pterygium patients was >4.04, with 80.4% sensitivity and 70.3% specificity.
CONCLUSION: The LY and the LMR were found to be significantly elevated in the pterygium group. However, LMR demonstrated relatively lower sensitivity and specificity. Elevated LMR may be a new systemic factor that deserves further evaluation in order to clarify the role of lymphocyte-mediated systemic inflammation in the occurrence of pterygium.

Keywords: Clinical tests, immunology, ocular surface surgery, pre-op medical testing, pterygium.