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Xingwu Zhong, Shaohui Gao; Changes in Ocular Surface and Tear Inflammatory Mediators after Small-incision Lenticule Extraction and Femtosecond Laser-assisted Laser in Situ Keratomileusis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1531.
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To compare the effects on ocular surface and levels of tear inflammatory mediators between small-incision lenticule extraction(ReLEx smile) and femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK) surgery.
fiffeen subjects underwent ReLEx smile and thirty-two subjects (32 eyes) underwent FS-LASIK were evaluated in this prospective study. Corneal fluorescein(FL) staining, tear break-up time(TBUT), schirmer I test (SIT) and ocular surface disease index(OSDI) were estimated. Tears were collected and assayed using multiplex magnetic bead for interleukin-6(IL-6), tumor necrosis factor-α (TNF-α), nerve growth factor(NGF) and intercellular adhesion molecule-1 (ICAM-1). The ocular surface parameters and tear inflammatory mediators were assessed preoperatively as well as at 1 day, 1 week ,1 month and 3 months postoperatively.
FL scores in ReLEx smile group were lower than that of FS-LASIK group at 1 week postoperatively(P=0.010). The longer TBUT in ReLEx smile group were observed than FS-LASIK at 1 month(P=0.029) and 3 months (P=0.045) after surgery. OSDI in FS-LASIK group were higher than ReLEx smile at 1 month (P=0.020). The higher central corneal sensitivity showed in ReLEx smile group at 1 week(P<0.05), 1 month(P<0.05) and 3 months(P<0.05) postoperatively. The lower concentrations of IL-6 were detected in ReLEx smile group than FS-LASIK group at 1 week(P=0.015) and 1 month(P=0.006) after surgery. NGF in tears of FS-LASIK group was higher than ReLEx smile at any visit(P<0.05). There were no obvious differences for TNF-α and ICAM-1 between two groups at any follow-up time. In ReLEx smile group, IL-6 levels correlated positively with OSDI (r=0.363,P=0.004), and negative correlation was found between NGF and central corneal sensitivity. In FS-LASIK group, IL-6 concentrations correlated positively with FL and OSDI.
There was a more superior condition of ocular surface for ReLEx smile than FS-LASIK at early period of postoperation. IL-6 and NGF were associated with the severity of ocular surface parameters after two surgeries.
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