Comparative analysis of two femtosecond LASIK platforms using iTRAQ quantitative proteomics

Area of Science:

• Ophthalmology
• Biochemistry
• Biomaterials Science

Background:

• Femtosecond laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery.
• Dry eye disease is a frequent complication following LASIK.
• Newer femtosecond laser platforms aim to minimize ocular surface disruption.

Purpose of the Study:

• To investigate and compare tear protein profiles after LASIK using two distinct femtosecond laser systems (Visumax and Intralase).
• To assess differences in protein expression related to ocular surface healing and dry eye markers.

Main Methods:

• A randomized, paired-eye clinical trial involving 22 patients undergoing LASIK.
• Corneal flap creation using either Visumax or Intralase femtosecond lasers.
• Tear samples collected preoperatively and at 1 week and 3 months postoperatively.
• Protein analysis using isobaric tagging for relative and absolute quantitation (iTRAQ) mass spectrometry.

Main Results:

• 824 unique proteins were identified and quantified.
• Differential regulation of tear proteins was observed between the two laser groups.
• Visumax treatment led to significant upregulation of Lipophilin A and C at 1 week.
• Intralase treatment showed upregulation of orosomucoid1 and downregulation of lysozyme, cathepsin B, and lipo-oxygenase at 1 week.
• Transglutaminase-2 was downregulated in both treatment groups.

Conclusions:

• Femtosecond laser platforms induce unique biological responses affecting tear protein composition.
• These distinct protein level changes suggest varying impacts on corneal wound healing and ocular surface homeostasis.
• Findings have implications for selecting surgical technology to optimize patient outcomes and manage post-LASIK dry eye.