Early Changes in Ocular Surface and Tear Inflammatory Mediators after Small-Incision Lenticule Extraction and Femtosecond Laser-Assisted Laser In Situ Keratomileusis

• Published in: PloS one Vol. 9; no. 9; p. e107370
• Main Authors: Gao, Shaohui, Li, Saiqun, Liu, Liangping, Wang, Yong, Ding, Hui, Li, Lili, Zhong, Xingwu
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.09.2014; Public Library of Science (PLoS)
• Subjects: Adhesion tests; Adult; Analysis; Anterior Eye Segment - pathology; Anterior Eye Segment - surgery; Beads; Cell adhesion; Chemokines; Contact lenses; Cornea; Cytokines; Eye diseases; Femtosecond lasers; Fluorescein; Growth factors; Humans; Inflammation; Inflammation Mediators - metabolism; Injuries; Intercellular adhesion molecule 1; Interleukin 6; Interleukin-6 - metabolism; Interleukin-6 - secretion; Keratomileusis, Laser In Situ; Laboratories; Laser in situ keratomileusis; Lasers; Medicine and Health Sciences; Molecular chains; Movie theaters; Myopia - metabolism; Myopia - surgery; Nerve growth factor; Patients; Prospective Studies; Sensitivity; Sensitivity analysis; Studies; Surgery; Tearing; Tears - metabolism; TNF inhibitors; Tumor necrosis factor; Tumor necrosis factor-α; Wound healing; Young Adult; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0107370

To characterize the early ocular-surface changes or tear inflammatory-mediators levels following small-incision lenticule extraction (ReLEx smile) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Forty-seven myopic subjects were recruited for this prospective study. Fifteen underwent ReLEx smile and thirty-two underwent FS-LASIK. Corneal fluorescein (FL) staining, tear break-up time (TBUT), Schirmer I test (SIT), ocular surface disease index (OSDI) and central corneal sensitivity were evaluated in all participants. Tears were collected and analyzed for interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF) and intercellular adhesion molecule-1 (ICAM-1) levels using multiplex magnetic beads. All measurements were preformed preoperatively and 1 day, 1 week, 1 month and 3 months postoperatively. FL scores in ReLEx smile group were lower than those of FS-LASIK group 1 week postoperatively (P = 0.010). Compared to the FS-LASIK group, longer TBUT were observed in ReLEx smile group 1 month (P = 0.029) and 3 months (P = 0.045) postoperatively. No significant differences were found in tear secretion for the two groups (P>0.05). OSDI scores were higher in FS-LASIK group 1 month after surgery (P = 0.020). Higher central corneal sensitivity was observed in ReLEx smile group 1 week, 1 month and 3 months (P<0.05) postoperatively. Compared to FS-LASIK group, lower and faster recovery of IL-6 and NGF levels in tears was observed in ReLEx smile group postoperatively (P<0.05). Tears TNF-α and ICAM-1 concentrations were not significantly different between the two groups at any follow-up time (P>0.05). Moreover, IL-6 and NGF levels correlated with ocular surface changes after ReLEx smile or FS-LASIK. In the early postoperative period, ReLEx smile results in milder ocular surface changes than FS-LASIK. Furthermore, the tear inflammatory mediators IL-6 and NGF may play a crucial role in the ocular surface healing process following ReLEx smile and FS-LASIK.