Posterior capsular opacification (PCO) remains a significant complication following cataract surgery, with an unclear pathogenesis in patients with high myopia. This study investigated the aqueous humor (AH) cytokine profile in patients with cataracts and high myopia and its relationship with the development of PCO.

AH samples were collected from 36 patients undergoing cataract surgery, including 18 with high myopia (axial length > 26 mm) and 18 age- and sex-matched controls. The levels of 19 PCO-associated cytokines were measured using a multiplex immunoassay, and PCO severity was assessed at 6 months postoperatively.

Compared to controls, patients with high myopia exhibited significantly elevated levels of vascular endothelial growth factor (VEGF)-C, hepatocyte growth factor (HGF), monocyte chemoattractant protein-1 (MCP-1), and osteopontin, alongside reduced VEGF-A levels (all P < 0.01). Axial length correlated positively with VEGF-C, HGF, MCP-1, and osteopontin but negatively with VEGF-A. Increased PCO severity was associated with higher VEGF-C, HGF, MCP-1, and osteopontin levels, while VEGF-A levels were inversely related.

These findings suggest that high myopia is linked to a distinct pro-inflammatory and pro-fibrotic cytokine environment, potentially exacerbating PCO. Identifying these cytokines as potential biomarkers may aid in early risk stratification and inform therapeutic strategies to prevent PCO in individuals with high myopia.