Early changes in tear film protein profiles after femtosecond LASIK surgery
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linical Proteomics Open Access
RESEARCH
Early changes in tear film protein profiles after femtosecond LASIK surgery Janika Nättinen1*† , Petri Mäkinen1,2†, Ulla Aapola1, Lasse Orsila1, Juhani Pietilä1,2 and Hannu Uusitalo1,3
Abstract Background: 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. Methods: 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). Results: 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. Conclusions: 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. Keywords: Refractive surgery, Femtosecond laser, LASIK, Tear proteomics, Wound healing Background Laser-assisted in situ keratomileusis (LASIK) is a safe and effective procedure for the correction of refractive errors. Therefore, it is one of the most frequently used laser eye surgery procedures and the patient satisfaction is generally high [1]. The operation is performed by creating a thin flap in the epithelium of cornea, for example with femtosecond laser, and then reshaping the *Correspondence: [email protected] † Janika Nättinen and Petri Mäkinen equally contributed to this work 1 SILK, Department of Ophthalmology, Faculty of Medicine and Health Technology, Tampere University, PL 100, 33014 Tampere, Finland Full list of author information is available at the end of the article
underlying corneal layer (stroma). Despite the very good clinical results, there are variations in LASIK’s effects and complications, which indicate individual differences in corneal and ocular surfa
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