Small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (LASIK) are widely used surgical methods to correct myopia with comparable efficacy, predictability, and safety. We examined and compared the early changes of tear protein profiles after SMILE and FS-LASIK surgery in order to find possible differences in the initial corneal healing process. SMILE operations for 26 eyes were made with Visumax femtosecond laser. In FS-LASIK surgery for 30 eyes, the flaps were made with Ziemer FEMTO LDV Z6 femtosecond laser and stromal ablation with Wavelight EX500 excimer laser. Tear samples were collected preoperatively, and 1.5 h and 1 month postoperatively using glass microcapillary tubes. Tear protein identification and quantification were performed with sequential window acquisition of all theoretical fragment ion spectra mass spectrometry (SWATH-MS). Immediately (1.5 h) after we found differences in 89 proteins after SMILE and in 123 after FS-LASIK operation compared to preoperative protein levels. Of these differentially expressed proteins, 48 proteins were common for both surgery types. There were, however, quantitative differences between SMILE and FS-LASIK. Upregulated proteins were mostly connected to inflammatory response and migration of the cells connected to immune system. One month after the operation protein expressions levels were returned to baseline levels with both surgical methods. Our study showed that immediate changes in protein profiles after SMILE and FS-LASIK surgeries and differences between the methods are connected to inflammatory process, and the protein levels quickly return to the baseline within 1 month. The differences in protein profiles between the methods are probably associated with the different size of the epithelial wound induced.

中文翻译：

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小切口角膜基质透镜摘除术 (SMILE) 和飞秒 LASIK (FS-LASIK) 手术后泪膜蛋白质谱早期变化的比较

小切口角膜基质透镜摘除术 (SMILE) 和飞秒激光辅助原位角膜磨镶术 (LASIK) 是广泛使用的矫正近视的手术方法，具有相当的疗效、可预测性和安全性。我们检查并比较了 SMILE 和 FS-LASIK 手术后泪液蛋白谱的早期变化，以发现初始角膜愈合过程中可能存在的差异。使用 Visumax 飞秒激光对 26 只眼睛进行了 SMILE 手术。在 30 只眼睛的 FS-LASIK 手术中，使用 Ziemer FEMTO LDV Z6 飞秒激光制作皮瓣，并使用 Wavelight EX500 准分子激光进行基质消融。使用玻璃微毛细管在术前、术后1.5小时和1个月收集泪液样本。通过连续窗口采集所有理论片段离子谱质谱法 (SWATH-MS) 进行泪液蛋白鉴定和定量。紧接着（1.5 小时），我们发现 SMILE 术后 89 种蛋白质和 FS-LASIK 手术后 123 种蛋白质与术前蛋白质水平相比存在差异。在这些差异表达的蛋白质中，有 48 种蛋白质对于两种手术类型都是常见的。然而，SMILE 和 FS-LASIK 之间存在数量上的差异。上调的蛋白质主要与炎症反应和与免疫系统相关的细胞迁移有关。手术后一个月，两种手术方法的蛋白质表达水平均恢复至基线水平。我们的研究表明，SMILE 和 FS-LASIK 手术后蛋白质谱的立即变化以及方法之间的差异与炎症过程有关，并且蛋白质水平在 1 个月内迅速恢复到基线。两种方法之间蛋白质谱的差异可能与诱导的上皮伤口的不同大小有关。