Femtosecond laser-assisted in situ keratomileusis (LASIK) has proven to be an efficacious, predictable, and safe procedure for the correction of refractive errors. We examined the early tear protein changes of patients undergoing LASIK surgery in order to better understand the mechanisms and proteins related to laser corneal surgery and initial recovery. Corneal flaps were created with Ziemer FEMTO LDV Z6 I femtosecond laser and stroma was ablated using Wavelight EX500 excimer laser. Tear samples were collected preoperatively as well as 1.5 h and 1 month after LASIK treatment using glass microcapillary tubes. Relative quantification of tear proteins was performed with sequential window acquisition of all theoretical fragment ion spectra mass spectrometry (SWATH-MS). SWATH-MS revealed that 158 proteins had altered expression levels 1.5 h after the operation. Two-thirds of these proteins, mostly connected to migration and inflammation response, returned to preoperative levels within the first postoperative month. The other proteins, which did not return to baseline levels, included proteins connected to for example epithelial barrier function. We also identified several proteins, which correlated with surgical variables, such as the amount of correction, flap thickness and flap diameter. The present study showed that an uneventful femtosecond LASIK refractive surgery induced a significant immune cell migration and inflammation-associated changes in tear proteomics profile quickly after the operation, but the expression of most proteins recovered almost completely to the preoperative levels within the first month. The individual proteins identified in our study are potential targets for the follow-up and modification of LASIK-induced biochemical processes.

中文翻译：

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飞秒 LASIK 手术后泪膜蛋白谱的早期变化

飞秒激光辅助原位角膜磨镶术 (LASIK) 已被证明是一种有效、可预测且安全的屈光不正矫正程序。我们检查了接受 LASIK 手术的患者的早期泪液蛋白变化，以便更好地了解与激光角膜手术和初始恢复相关的机制和蛋白质。角膜瓣用 Ziemer FEMTO LDV Z6 I 飞秒激光制作，基质用 Wavelight EX500 准分子激光消融。使用玻璃微毛细管在术前以及 LASIK 治疗后 1.5 小时和 1 个月收集泪液样本。泪液蛋白的相对定量是通过所有理论碎片离子光谱质谱 (SWATH-MS) 的顺序窗口采集来进行的。SWATH-MS 显示 158 种蛋白质的表达水平发生了改变 1。术后5小时。这些蛋白质中的三分之二，主要与迁移和炎症反应有关，在术后第一个月内恢复到术前水平。其他没有恢复到基线水平的蛋白质包括与例如上皮屏障功能相关的蛋白质。我们还确定了几种与手术变量相关的蛋白质，例如矫正量、皮瓣厚度和皮瓣直径。本研究表明，顺利的飞秒 LASIK 屈光手术在术后迅速引起了明显的免疫细胞迁移和炎症相关的泪液蛋白质组学变化，但大多数蛋白质的表达在第一个月内几乎完全恢复到术前水平。