Specific human IgG and IgE response to corneal antigens following Lasik

Abstract

Abstract: : Purpose: To determine if there is systemic allergic response to corneal antigens in Lasik surgery. Methods: Two types of corneal extracts, with and without excimer laser ablations, were obtained from fresh human eye bank buttons. They were macerated, centrifuged in PBS with a final protein concentration at 10mg/ml. Specific IgG and IgE antibodies against human corneal protein were measured by Elisa in a blind manner, in the following groups: 1) 20 Lasik surgeons (n:10) and close surgical assistants (n:10), performing over 250 monthly Lasik surgeries over the past 7 years; 2) 20 normal age–matched controls, and 3) in 20 active Lupic (SLD) patients. All patients underwent a complete clinical immunologic exam to evaluate for atopic respiratory symptoms. The results were considered (+) when more than 2 SD from the normal were found, and highly specific with ≥ 3 SD. Statistical analysis were made with ANOVA test using SPSS software. Results: Group 1) had 4 (+) cases out of 20, 1 against IgG, 2 against IgG and IgE combined, and 1 against IgE alone which was highly specific. Group 2) Normal (n: 20) all with negative responses; Group 3) sera from patients with active lupus (n: 20), all negative. Group 1> p.005 over groups 2 and 3. No differences were noted between proteins of corneas with or without laser ablations. Conclusion: A clear allergic response to human corneal protein is found for the first time in sera of some individuals closely working in Lasik surgery. Further experimental and human studies are under way.

Keywords: refractive surgery: LASIK • cornea: basic science • immunomodulation/immunoregulation