ABSTRACT:

Any form of refractive surgery results in neuropathic ocular surface. My work investigated, compared and correlated the longitudinal data on ocular surface clinical variables, corneal nerve imaging parameters, tear neuromediators and proteomes following small incision lenticule extraction (SMILE) and laser in-situ keratomileusis (LASIK), the two most common refractive procedures.

My work found that the postoperative corneal denervation was long-lasting, with faster recovery following SMILE. SMILE was associated with less negative impact on ocular surface clinically, as well as less fluctuation in neuroinflammatory reaction. Corneal nerve parameters were significantly associated with several ocular surface changes, such as tear break-up time, corneal staining and Schirmer’s values. I also identified tear proteins, such asmammaglobin-B, lactotransferrin, lacritin and zinc-alpha-2- glycoprotein, were significantly associated with a neuropathic ocular surface. Substance P, calcitonin gene-related peptide, neuropeptide Y, pigment epithelium−derived factor, elafin, complement decay accelerating factor, proline-rich protein 27, nucleobindin-2, and lipocalin-1, were significantly associated with corneal nerve metrics.

This is the first study to comprehensively evaluate and link between molecular profiles, nerve morphological changes and clinical functional changes for patients following refractive surgery. The molecules identified have the potential to be biomarkers for neuropathic ocular surface, as well as new treatments to enhance neurotrophic ocular surface health.

THESIS ADVISOR:  
Prof. Jodhbir Mehta

VENUE: 
Duke-NUS, Level 2, Amphitheatre