The Differential Expression of Cytokines and Growth Factors After SMILE Compared With FS-LASIK in Rabbits.

Purpose: To investigate the differential expression of cytokines and growth factors in the cornea and aqueous humor after small incision lenticule extraction (SMILE) compared with femtosecond LASIK (FS-LASIK) using rabbit model. Methods: Sixteen eyes of 16 rabbits in each group underwent SMILE or FS-LASIK with refractive correction of -6.00 DS/-1.00 DC. Eight additional rabbits served as controls. Pre- and 24 hours, 1 week, 1 month, and 3 months postoperatively, slit-lamp and anterior segment optical coherence tomography were performed, followed by cornea and aqueous humor collection. Apoptosis and proliferation were evaluated with TUNEL assay and Ki-67 immunostaining, respectively. The mRNA and protein expression of cytokines and growth factors was determined by RT-qPCR and Western blotting, respectively. Cytokine levels in the aqueous humor were detected with ELISA. Results: Compared with FS-LASIK, SMILE induced less apoptosis and proliferation in the cornea within 1 week postoperatively. Levels of IL-1ß, TNF-α, and EGFR in the cornea were significantly increased after FS-LASIK compared with SMILE within 24 hours. Levels of IL-8 in the aqueous humor remained elevated until 1 week after FS-LASIK but not SMILE. TGF-ß1 level was elevated up to 1 month after both procedures, while BFGF level was kept high within 1 month after SMILE but not FS-LASIK. Conclusions: SMILE could induce significantly less acute inflammation than FS-LASIK in the cornea and aqueous humor. The differential expression of TGF-ß1 and BFGF between two procedures until 1 month might contribute to the post-SMILE delayed recovery and underline the importance of continued treatment postoperatively.

In Vitro Evaluation of the Effects of Intraocular Lens Material on Lens Epithelial Cell Proliferation, Migration, and Transformation.

OBJECTIVE: To investigate the biological effects of different intraocular lens (IOL) materials on the adhesion, migration, morphology, and epithelial-to-mesenchymal transition (EMT) of human lens HLEB3 cells. MATERIALS AND METHODS: Human HLEB3 cells were seeded onto IOLs composed of four different materials (polymethyl methacrylate (PMMA), silicone elastomer, hydrophilic acrylic, and hydrophobic acrylic). The levels of cellular adhesion, migration, morphology, and EMT were then quantified using a cell viability assay, scratch test, phase contrast microscopy, and immunofluorescence staining, respectively. RESULTS: The highest levels of HLEB3 cell adhesion and migration were found for the hydrophobic acrylic IOL cultures, which also had the lowest incidence of EMT (p < 0.01). In contrast, while the PMMA IOLs had a low level of cell adhesion, the percentage of these cells undergoing EMT was the highest compared to the other groups (p < 0.001). The hydrophilic IOLs were also associated with an extremely low level of cellular adhesion, which ultimately prevented any further analysis. Finally, while the HLEB3 cells cultured with silicon IOLs were similar to those cultured with hydrophobic acrylic IOLs in terms of morphology and EMT levels, they had significantly lower adhesion and migration profiles. CONCLUSION: Taken together, these data suggest that IOL composition greatly affects lens cell behavior during PCO development, and it appears that hydrophobic IOLs may be the best option to limit the effects of PCO after cataract surgery while also correcting the patient's vision.