Comparison of early changes in ocular surface markers and tear inflammatory mediators after femtosecond lenticule extraction and FS-LASIK

Chi Zhang; Hui Ding; Hong He; He Jin; Liang-Ping Liu; Xiao-Wei Yang; Jun Yang; Xing-Wu Zhong

doi:10.18240/ijo.2021.02.16

Comparison of early changes in ocular surface markers and tear inflammatory mediators after femtosecond lenticule extraction and FS-LASIK

Int J Ophthalmol. 2021 Feb 18;14(2):283-291. doi: 10.18240/ijo.2021.02.16. eCollection 2021.

Authors

Chi Zhang^{1

2}, Hui Ding³, Hong He³, He Jin², Liang-Ping Liu², Xiao-Wei Yang², Jun Yang², Xing-Wu Zhong^{2

3}

Affiliations

¹ Huaxia Eye Hospital of Foshan, Huaxia Eye Hospital Group, Foshan 528000, Guangdong Province, China.
² Zhongshan Ophthalmic Center and State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.
³ Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou 570311, Hainan Province, China.

Abstract

Aim: To compare the short-term impacts of femtosecond lenticule extraction (FLEx) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) on ocular surface measures and tear inflammatory mediators.

Methods: This prospective comparative nonrandomized clinical study comprised 75 eyes (75 patients). Totally 20 male and 15 female patients (age 21.62±3.25y) with 35 eyes underwent FLEx, and 26 male and 14 female patients (age 20.18±3.59y) with 40 eyes underwent FS-LASIK. Central corneal sensitivity, noninvasive tear breakup time, corneal fluorescein staining, Schirmer I test, tear meniscus height, and ocular surface disease index were evaluated in all patients. Tear concentrations of nerve growth factor (NGF), interleukin-1α (IL-1α), transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and matrix metalloproteinase-9 (MMP-9) were assessed by multiplex antibody microarray. All measurements were performed preoperatively, and 1d, 1wk, and 1mo postoperatively.

Results: Patients who underwent FLEx exhibited a more moderate reduction in central corneal sensation and less corneal fluorescein staining than those in the FS-LASIK group 1wk after the procedure (P<0.01). NGF was significantly higher 1d and 1wk after surgery in the FS-LASIK group than in the FLEx group (P<0.01). By contrast, compared to those in the FLEx group, higher postoperative values and slower recovery of tear TGF-β1, IL-1α, and TNF-α concentrations were observed in the FS-LASIK group (P<0.01). Tear concentrations of NGF, TGF-β1, TNF-α, and IL-1α were correlated with ocular surface changes after FLEx or FS-LASIK surgery.

Conclusion: There is less early ocular surface disruption and a reduced inflammatory response after FLEx than after FS-LASIK. NGF, TGF-β1, TNF-α, and IL-1α may contribute to the process of ocular surface recovery.

Keywords: femtosecond laser-assisted laser in situ keratomileusis; femtosecond lenticule extraction; ocular surface; tear inflammatory mediators.

International Journal of Ophthalmology Press.