Introduction

The tear proteomics and neuromediators are associated with clinical dry eye parameters following refractive surgery.

Purpose

To investigate and compare the tear proteomic and neuromediator profiles following small incision lenticule extraction (SMILE) versus laser-assisted in-situ keratomileusis (LASIK).

Methods

In this randomized controlled trial with paired-eye design, 70 patients were randomized to receive SMILE in one eye and LASIK in the other eye. Tear samples were collected preoperatively, and 1 week, 1, 3, 6 and 12 months postoperatively, and were examined for protein concentration changes using sequential window acquisition of all theoretical fragment ion mass spectrometry (SWATH-MS). The data were analyzed with DAVID Bioinformatics Resources for enriched gene ontology terms and over-represented pathways. Tear neuromediators levels were correlated with clinical parameters.

Results

Post-SMILE eyes had significantly better Oxford staining scores and tear break-up time (TBUT) than post-LASIK eyes at 1 and 3 months, respectively. Tear substance P and nerve growth factor levels were significantly higher in the LASIK group for 3 months and 1 year, respectively. SMILE and LASIK shared some similar biological responses postoperatively, but there was significant up-regulation in leukocyte migration and wound healing at 1 week, humoral immune response and apoptosis at 1 month, negative regulation of endopeptidase activity at 3 to 6 months, and extracellular structure organization at 1 year in the post-LASIK eyes. Tear mucin-like protein 1 and substance P levels were significantly correlated with TBUT (r = -0.47, r = -0.49, respectively).

Conclusion

Significant differences in the tear neuromediators and proteomics were observed between SMILE and LASIK, even though clinical dry eye signs have subsided and became comparable between 2 procedures.

中文翻译：

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小切口微透镜提取 (SMILE) 和飞秒激光辅助原位角膜磨镶术 (LASIK) 之间泪液蛋白质组学和神经介质特征变化的比较

介绍

泪液蛋白质组学和神经介质与屈光手术后的临床干眼参数有关。

目的

研究和比较小切口微透镜提取 (SMILE) 与激光辅助原位角膜磨镶术 (LASIK) 后的泪液蛋白质组学和神经介质特征。

方法

在这项双眼设计的随机对照试验中，70 名患者随机接受一只眼睛的 SMILE 和另一只眼睛的 LASIK。在术前和术后 1 周、1、3、6 和 12 个月收集泪液样本，并使用所有理论碎片离子质谱法 (SWATH-MS) 的顺序窗口采集检查蛋白质浓度变化。使用 DAVID 生物信息学资源对数据进行了分析，以获取丰富的基因本体术语和过度表达的途径。泪液神经介质水平与临床参数相关。

结果

分别在 1 个月和 3 个月时，SMILE 后眼睛的牛津染色评分和泪液破裂时间 (TBUT) 显着优于 LASIK 后眼睛。LASIK 组的泪液 P 和神经生长因子水平分别显着升高 3 个月和 1 年。SMILE和LASIK术后有一些相似的生物学反应，但1周时白细胞迁移和伤口愈合显着上调，1个月时体液免疫反应和细胞凋亡，3-6个月内肽酶活性负调节，细胞外结构LASIK 术后 1 年的组织。泪液粘蛋白样蛋白 1 和 P 物质水平与 TBUT 显着相关（分别为r  = -0.47，r  = -0.49）。

结论

在 SMILE 和 LASIK 之间观察到泪液神经介质和蛋白质组学的显着差异，即使临床干眼症状已经消退并在 2 个程序之间变得可比。