Clinical and tear cytokine profiles after advanced surface ablation refractive surgery: A six-month follow-up

María J González-García; Giovanna M Murillo; José Pinto-Fraga; Noelia García; Itziar Fernández; Miguel J Maldonado; Margarita Calonge; Amalia Enríquez-de-Salamanca

doi:10.1016/j.exer.2020.107976

Clinical and tear cytokine profiles after advanced surface ablation refractive surgery: A six-month follow-up

Exp Eye Res. 2020 Apr:193:107976. doi: 10.1016/j.exer.2020.107976. Epub 2020 Feb 17.

Authors

María J González-García¹, Giovanna M Murillo², José Pinto-Fraga², Noelia García², Itziar Fernández³, Miguel J Maldonado², Margarita Calonge³, Amalia Enríquez-de-Salamanca³

Affiliations

¹ IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine), Valladolid, Spain. Electronic address: mjgonzalez@ioba.med.uva.es.
² IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain.
³ IOBA (Institute of Applied Ophthalmobiology), University of Valladolid, Campus Miguel Delibes, Paseo de Belén 17, 47011, Valladolid, Spain; CIBER-BBN (Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine), Valladolid, Spain.

PMID: 32081669
DOI: 10.1016/j.exer.2020.107976

Abstract

Neuropathic dry eye is one of the most frequently seen complications after corneal refractive surgery, however, its incidence decreases in a significant manner along the first six months postoperative, reaching between 10 and 45% incidence. However, little is known on the inflammatory status of the ocular surface during this recovery process. We aim to analyze the clinical and tear molecule concentration changes along six months after advanced surface ablation for myopia correction, in a prospective study including 18 eyes of 18 subjects who bilaterally underwent advanced surface ablation corneal refractive surgery. Clinical variables (uncorrected distance visual acuity, symptoms, conjunctival hyperemia, tear osmolarity, tear stability, corneal fluorescein staining, conjunctival lissamine staining, Schirmer test, and corneal esthesiometry) and a panel of 23 pro and anti-inflammatory cytokines/chemokines concentration in tears preoperatively and at 1, 3 and 6 months postoperatively were evaluated. We found that uncorrected distance visual acuity improved significantly from baseline at 1-month visit, symptoms improved and tear osmolarity decreased significantly from baseline at 3-month visit and there was a decrease in mechanical corneal threshold between 1-month and 3- and 6-month visits. Regarding tear molecules, IL-4, IL-5, IL-6, IL-13, IL-17A, and IFN-γ tear levels were significantly increased at all the three visits, compared to preoperative levels at V0; IL-2 and VEGF were also significantly increased at 1-month and 6-month visits, but not at 3-month visit, whereas IL-9 IL-10 and IL-12 were only significantly increased at 6-month visit. Although we found that there is a recovery in clinical variables at 6 months postoperatively (i.e. neuropathic dry eye was not developed in the sample), ocular surface homeostasis is not completely restored, as it can be seen by the changes in concentration of some pro and anti-inflammatory molecules measured in tears.

Keywords: Advanced surface ablation; Cytokines; Dry eye disease; Ocular surface inflammation; Refractive surgery.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Biomarkers / metabolism
Cytokines / metabolism*
Dry Eye Syndromes / diagnosis
Dry Eye Syndromes / etiology
Dry Eye Syndromes / metabolism*
Female
Follow-Up Studies
Humans
Laser Therapy / adverse effects*
Male
Middle Aged
Osmolar Concentration
Prospective Studies
Refractive Surgical Procedures / adverse effects*
Tears / metabolism*
Time Factors
Visual Acuity

Substances

Biomarkers
Cytokines