Shared molecular profiles of post-laser vision correction ectasia and keratoconus with key differences in , , , and .

INTRODUCTION

Post-laser vision correction (post-LVC) ectasia is a serious complication that is observed in 0.033%-0.66% of corneal refractive surgeries. Similar to keratoconus (KTCN), post-LVC ectasia is classified under the category of "ectatic diseases." We hypothesize that although the mechanistic aspects of post-LVC ectasia and KTCN are distinct, there are notable similarities in the epithelial responses, including shared molecular features.

METHODS

A total of 11 post-LVC ectasia, 8 mild myopia (controls), and 28 KTCN patients were included in a retrospective multiomics case-control study. The corneal epithelium (CE) samples obtained from the subjects were separated into different ( and ), and a total of 159 experimental samples were subjected to transcriptome (RNA-Seq) and proteome (MALDI-TOF/TOF MS/MS) profiling. The results were then verified/validated using reverse transcription quantitative polymerase chain reaction, immunofluorescence staining, and confocal microscopy in the extended sample set (n = 21).

RESULTS

The residual stromal bed, stromal ablation depth, and percent tissue altered indices were found to best predict the risk of post-LVC ectasia. From comparisons of post-LVC ectasia and KTCN, interferon-alpha and interferon-gamma hallmarks were found to be downregulated in the and of the CE of patients with post-LVC ectasia. Downregulation of gene expression was confirmed in all three in the extended CE sample set. Cytoplasmic localizations of the CIITA and TBC1D4 proteins, which are the candidate post-LVC ectasia-specific biomarkers, were demonstrated in the CE samples.

DISCUSSION

The assessment of , and gene expressions could enhance the risk estimation of ectasia in patients. Apart from differences in the transcription and inflammation processes, the CE of patients with post-LVC ectasia exhibits molecular features similar to KTCN.