PROTEOMIC DIAGNOSTIC TECHNOLOGIES AND THEIR APPLICATION FOR THE REFRACTIVE CORRECTION OF AMETROPIA

Abstract

Aim. The objective of the present study was the analysis of the tear fluid proteomic status and the eye surface of the patients presenting with ametropia before and after laser-assisted in situ keratomileusis (LASIK). Material and methods. The study included 163 patients (326 eyes) divided into three groups. Group 1 was comprised of 51 adult patients (102 eyes)at the age from 35 to 54 years suffering from high-degree myopia and astigmatism. Group 2 was composed of 26 adult patients (52 eyes) at the age from 35 to 55 years suffering from moderate or high-degree hyperopia and astigmatism. Group 3 consisted of 86 younger patients (172 eyes) at the age from 18 to 54 years suffering from high-degree myopia and astigmatism. The dry eye syndrome and the state pf the cornea were diagnosed with the use of the Lipkof’s test, Schirmer’s test, TBUT test, and corneal fluorescence staining. The antioxidant activity of the tears was estimated based on the results of measurements of peroxyredoxin-6 (PEDX6) expression. Results. The level of PEDX6 expression after LASIK increased in the patients presenting with myopia by 1.4 times and in those with hyperopia by 1.07 times, that is it changed but slightly after the operation and was 6.2 times less pronounced in comparison was the myopes. Conclusion. The study has demonstrated that two methods proved reliable for the evaluation of the tear fluid proteomic status, viz. the Lipkof’s test (1.82 ± 0.2mm, stage 3) and the TBUT test (8.0 ± 1.46 seconds), suggesting the presence of grade 2 dry eye syndrome. Te same refers to the patients of group 2: the results of the Lipkof’s test (1.31 ± 0.2mm) and the TBUT test (8.23 ± 0.87 seconds). The level of antioxidant protection of the ocular surface (PEDX6 expression) depended on the type of the refractive error: in the patients of group 1 before and after LASIK, PEDX6 expression was 4.7 times (13.57 ± 0.83) and 6.2 (19.31 ± 0.71) higher 2.88 ± 0.38 and 3.09 ± 0.47) than in those of group 2, respectively. In addition, it was shown that the level of antioxidant protection of the ocular surface (PEDX6 expression) depended on the age of the patients prior to LASIK: it was 1.3 lower in group 1 than in group 3 (1.35 ± 0.83 and 17.77 ± 1.03 respectively). The clinical significance of the tests for the tear fluid production and proteomic status changed appreciably after LASIK. The TBUT test for diagnostics of dry eye syndrome remained reliable in all the groups.