Understanding structural healing of cornea after SMILE and LASIK and their comparison

Session Details

Session Title: LASIK: Flap Morphology and Ablation Profile

Session Date/Time: Monday 09/10/2017 | 08:30-10:20

Paper Time: 09:58

Venue: Room 3.6

First Author: : K.Sainani INDIA

Co Author(s): :    R. Shetty   K. Nishtala   A. Ghosh   P. Kusumgar           

Abstract Details

Purpose:

Laser in situ keratomileusis (LASIK) and small incision lenticule extraction (SMILE) involve procedural differences which might elicit different wound healing responses.Using quantitative proteomics, we investigated molecular changes post LASIK and SMILE in corneal stroma of cadaver eyes that may explain differences in long term stability following each procedure.

Setting:

Grow Research Laboratories, Narayana Nethralaya Foundation, Bangalore, India

Methods:

Cadaver eyes (n=3) not suitable for transplantation were subjected to LASIK and SMILE surgeries.The corneas were treated for myopia of -6D and ablation of 74-75µ and 65-66µ stromal depth for LASIK and SMILE respectively.Stromal tissue from each eye post-surgery stored at -80°C was considered for proteomic analysis. Protein extraction was carried out by pulverizing stromal tissue in liquid nitrogen with protein extraction buffer. The peptides from LASIK and SMILE stroma were differentially labeled using iTRAQ reagents 114 and 117 respectively and analyzed by mass spectrometry.

Results:

Proteomic analysis identified over 400 proteins in corneal stroma of these eyes. Increased cytokeratins and cell cycle proteins were observed after SMILE compared to LASIK indicating enhanced/ faster wound healing in SMILE. Extra cellular matrix(ECM) proteins collagen 6 α1, α2 and pro-collagen endopeptidase enhancer-1 were lower in SMILE indicating less remodeling. Lower levels of pro-inflammatory Lysozyme C in SMILE indicated a modulated inflammatory response.

Conclusions:

Quantitative proteomic analysis of corneal stroma demonstrated enhanced wound healing, less inflammation and stable ECM in SMILE compared with LASIK.This molecular signature may be responsible for biomechanical stability and faster healing of cornea following SMILE. Further studies are warranted to evaluate long term impact on developing ectasia and topographic changes following either procedures.

Financial Disclosure:

NONE