Changes in tear protein composition of patients who underwent photorefractive keratectomy (PRK) were analyzed.
Methods
Tear samples were obtained from 23 eyes of 23 patients immediately before PRK and on the fourth postoperative day with glass capillaries. Tear proteins were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Digital image analysis and evaluation of the densitometric data of the electrophoretic separations were done with BioDoc-Analyze.
Results
Analysis of discriminance found a significant difference in the protein patterns (p<0.001). This type of analysis of the electrophoretic densitographs uses all peak information simultaneously. A significant decrease (p<0.005) in three of the main protein peaks – lactoferrin, immunoglobulin A heavy chain, and lysozyme – was also found after PRK.
Conclusions
Excimer laser ablation of the cornea has an acute effect on lacrimal gland protein secretion. Changes in tear composition may lead to feelings of dryness and to a decrease in tear film stability postoperatively.
MurphyP.J.CorbettM.C.O'BrartD.P.VermaS.PatelS.MarshallJ.. Loss and recovery of corneal sensitivity following photorefractive keratectomy for myopia.J Refract Surg1999; 15: 38–45.
2.
KauffmannT.BodanowitzS.HesseL.KrollP.. Corneal reinnervation after photorefractive keratectomy and laser in situ keratomileusis: an in vivo study with a confocal videomicroscope.Ger J Ophthalmol1996; 5: 508–12.
3.
Te rvoT.VirtanenT.HonkanenN.HarkonenM.TarkkanenA.. Tear fluid plasmin activity after excimer laser photorefractive keratectomy.Invest Ophthalmol Vis Sci1994; 35: 3045–50.
4.
CsutakA.TozserJ.BekesiL.HassanZ.BertaA.SilverD.M.. Plasminogen activator activity in tears after excimer laser photorefractive keratectomy.Invest Ophthalmol Vis Sci2000; 41: 3743–7.
5.
VesaluomaM.H.TervoT.T.. Tenascin and cytokines in tear fluid after photorefractive keratectomy.J Refract Surg1998; 14: 447–54.
6.
MertaniemiP.YlatupaS.PartanenP.TervoT.. Increased release of immunoreactive calcitonin gene-related peptide (CGRP) in tears after excimer laser keratectomy.Exp Eye Res1995; 60: 659–65.
BilgihanA.BilgihanK.TokluY.KonukO.YisO.HasanreisogluB.. Ascorbic acid levels in human tears after photorefractive keratectomy, transepithelial photorefractive keratectomy, and laser in situ keratomileusis.J Cataract Refract Surg2001; 27: 585–8.
9.
MackieI.A.SealD.V.. Diagnostic implication of tear protein profiles.Br J Ophthalmol1984; 68: 321–4.
10.
JanssenP.T.van BijsterveldO.P.. A simple test for lacrimal gland function: a tear lactoferrin assay by radial immunodiffusion.Graefes Arch Clin Exp Ophthalmol1983; 220: 171–4.
11.
GorenM.B.GorenS.B.. Diagnostic tests in patients with symptoms of keratoconjunctivitis sicca in clinical practice.Am J Ophthalmol1988; 106: 570–4.
12.
JensenO.L.GluudB.S.BirgensH.S.. The concentration of lactoferrin in tears during post-operative ocular inflammation.Acta Ophthalmol1985; 63: 341–5.
13.
JensenO.L.SandB.. Lactoferrin and serum albumin in the conjunctival fluid of eyes operated for senile cataract.Acta Ophthalmol1987; 65: 393–6.
14.
GrusF.H.SabuncuoP.AugustinA.J.. Quantitative analysis of tear protein profile for soft contact lenses-a clinical study.Klin Monatsbl Augenheilkd2001; 218: 239–42.
15.
GrusF.H.AugustinA.J.. Protein analysis methods in diagnosis of sicca syndrome.Ophthalmologe2000; 97: 54–61.
16.
GrusF.H.AugustinA.J.. Analysis of tear protein patterns by a neural network as a diagnostical tool for the detection of dry eyes.Electrophoresis1999; 20: 875–80.
17.
HerberS.GrusF.H.SabuncuoP.AugustinA.J.. Two-dimensional analysis of tear protein patterns of diabetic patients.Electrophoresis2001; 22: 1838–44.
18.
HannaK.D.PouliquenY.M.WaringG.O.SavoldelliM.FantesF.ThompsonK.P.. Corneal wound healing in monkeys after repeated excimer laser photorefractive keratectomy.Arch Ophthalmol1992; 110: 1286–91.
19.
TsubotaK.. The importance of the Schirmer test with nasal stimulation.Am J Ophthalmol1991; 111: 106–8.
20.
LaemmliU.K.. Cleavage of structural proteins during the assembly of head of bacteriophage T4.Nature1970; 227: 680–5.
21.
GrusF.H.NuskeJ.H.. Densitometrie mit dem EPSON Scanner GT-6000. In: Schemel-TrumpfhellerC.K., ed. GIT-Laborjahrbuch 1991.Darmstadt: GIT Verlag; 1991: 234–5.
22.
NuskeJ.H.GrusF.H.. Moderne densitometrie.Bio Tec1993; 2: 33–5.
JanssenP.T.van BijsterveldO.P.. Origin and biosynthesis of human tear fluid proteins.Invest Ophthalmol Vis Sci1983; 24: 623–30.
25.
FullardR.J.TuckerD.L.. Changes in human tear protein levels with progressively increasing stimulus.Invest Ophthalmol Vis Sci1991; 32: 2290–301.
26.
FullardR.J.SnyderC.. Protein levels in nonstimulated and stimulated tears of normal human subjects.Invest Ophthalmol Vis Sci1990; 31: 1119–26.
27.
BertaA.. Standardization of tear protein determinations: the effect of sampling, flow rate and vascular permeability. In: HollyF.J., ed. The precorneal tear film in health, disease and contact lens wear.Lubbock, TX: Dry Eye Institute; 1986: 418–35.
28.
DarttD.A.. Signal transduction and control of lacrimal gland protein secretion: a review.Curr Eye Res1989; 8: 619–36.
29.
LeeJ.B.RyuC.H.KimJ.KimE.K.KimH.B.. Comparison of tear secretion and tear film instability after photorefractive keratectomy and laser in situ keratomileusis.J Cataract Refract Surg2000; 26: 1326–31.
30.
HovanesianJ.A.ShahS.S.MaloneyR.K.. Symptoms of dry eye and recurrent erosion syndrome after refractive surgery.J Cataract Refract Surg2001; 27: 577–84.
31.
Van HaeringenN.J.. Clinical biochemistry of tears.Surv Ophthalmol1981; 26: 84–96.
