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Tear Martix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 in Post-Lasik Ectasia

  • Mohamed Nagy Elmohamady
  • Walid Abdelghaffar
  • Tamer Ibrahim Salem
Original Paper

Abstract

Purpose

To estimate the concentrations of matrix metalloproteinase-9 (MMP-9) and tissue inhibitors of metalloproteinase-1 (TIMP-1) in the tear film of cases with post-Lasik ectasia (PLE) to spot any role of these mediators.

Settings

Ophthalmology department, Benha University hospitals, Egypt.

Methods

Twelve eyes of 12 patients with PLE, 30 eyes of 30 patients with KC, 25 eyes of 25 subjects with uncomplicated Lasik and finally 25 eyes of 25 healthy subjects as a control group were studied. Subjects with ocular surface diseases, previous ocular surgeries except for Lasik in PLE group and Lasik group, were excluded. All subjects had full ophthalmic examination and Pentacam imaging. The concentration of tear MMP-9 and TIMP-1 was measured by ELISA.

Results

Our results showed a significant elevation in the level of MMP-9 and a significant reduction in the level of TIMP-1 in tear samples from PLE cases (MMP-9 was 59.17 ± 28.15 ng/ml, and TIMP-1 was 110.3 ± 50.6 ng/ml) and also in KC cases (MMP-9 was 53.12 ± 17.35 ng/ml, and TIMP-1 was 105.8 ± 56.3 ng/ml) when compared to post-Lasik group (MMP-9 was 35.65 ± 17.32 ng/ml, and TIMP-1 was 155.2 ± 39.4 ng/ml) and control group (MMP-9 was 31.92 ± 20.78 ng/ml, and TIMP-1 was 162.5 ± 48.2 ng/ml).

Conclusion

The results pointed to potential role of MMP-9 in the pathogenesis of PLE and also referred to a biochemical similarity between PLE and KC. More studies are needed in the future to investigate larger number of tear mediators.

Keywords

Post-Lasik ectasia MMP-9 TIMP-1 Keratoconus Lasik 

Notes

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Benha University Research Ethics Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.

References

  1. 1.
    Rebenitsch RL, Kymes SM, Walline JJ, Gordon MO (2011) The lifetime economic burden of keratoconus: a decision analysis using a markov model. Am J Ophthalmol 151:768–773.  https://doi.org/10.1016/j.ajo.2010.10.034 PMID: 21310384 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Jinabhai A, O’Donnell C, Radhakrishnan H (2012) Changes in refraction, ocular aberrations, and corneal structure after suspending rigid gas-permeable contact lens wear in keratoconus. Cornea 31:500–508.  https://doi.org/10.1097/ICO.0b013e31820f777b CrossRefPubMedGoogle Scholar
  3. 3.
    Padmanabhan P, Reddi SR, Sivakumar PD (2016) Topographic, tomographic, and aberrometric characteristics of post-LASIK ectasia. Optom Vis Sci 93(11):1364–1370CrossRefPubMedGoogle Scholar
  4. 4.
    Seiler T, Koufala K, Richter G (1998) Iatrogenic keratectasia after laser in situ keratomileusis. J Refract Surg 14:312Y7Google Scholar
  5. 5.
    Randelman JB, Russell B, Ward MA, Thompson KP, Stulting RD (2003) Risk factors and prognosis for corneal ectasia after LASIK. Ophthalmology 110:267–275CrossRefGoogle Scholar
  6. 6.
    Lema I, Duran JA (2005) Inflammatory molecules in the tears of patients with KC. Ophthalmology 112:654–659CrossRefPubMedGoogle Scholar
  7. 7.
    Balasubramanian SA, Mohan S, Pye DC, Willcox MD (2012) Proteases, proteolysis and inflammatory molecules in the tears of people with keratoconus. Acta Ophthalmol 90:e303–e309.  https://doi.org/10.1111/j.1755-3768.2011.02369 CrossRefPubMedGoogle Scholar
  8. 8.
    Collier SA (2001) Is the corneal degradation in keratoconus caused by matrix-metalloproteinases? Clin Exp Ophthalmol 29:340–344CrossRefPubMedGoogle Scholar
  9. 9.
    Shetty R, Ghosh A, Lim RR, Subramani M, Mihir K, Reshma AR, Ranganath A, Nagaraj S, Nuijts RM, Beuerman R, Shetty R, Das D, Chaurasia SS, Sinha-Roy A, Ghosh A (2015) Elevated expression of matrix metalloproteinase-9 and inflammatory cytokines in keratoconus patients is inhibited by cyclosporine A. Invest Ophthalmol Vis Sci 56(2):738–750.  https://doi.org/10.1167/iovs.14-14831 CrossRefPubMedGoogle Scholar
  10. 10.
    Esquenazi S, Esquenazi I, Grunstein L, He J, Bazan H (2009) Immunohistological evaluation of the healing response at the flap interface in patients With LASIK ectasia requiring penetrating keratoplasty. J Refract Surg (Thorofare, NJ: 1995) 25(8):739–746CrossRefGoogle Scholar
  11. 11.
    Hagan S, Martin E, Enríquez-de-Salamanca A (2016) Tear fluid biomarkers in ocular and systemic disease: potential use for predictive, preventive and personalized medicine. EPMA J 7:15.  https://doi.org/10.1186/s13167-016-0065-3 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Pahuja NK, Shetty R, Deshmukh R, Sharma A, Nuijts RMMA, Jhanji V, Sethu S, Ghosh A (2017) In vivo confocal microscopy and tear cytokine analysis in post-LASIK ectasia. Br J Ophthalmol.  https://doi.org/10.1136/bjophthalmol-2016-309142 [Epub ahead of print] PubMedGoogle Scholar
  13. 13.
    Jhanji V, Sharma N, Vajpayee RB (2011) Management of keratoconus: current scenario. Br J Ophthalmol 95:1044–1050CrossRefPubMedGoogle Scholar
  14. 14.
    Galvis V, Sherwin T, Tello A, Merayo J, Barrera R, Acera A (2015) Keratoconus: an inflammatory disorder? Eye 29(7):843–859.  https://doi.org/10.1038/eye.2015.63 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Smith V, Rishmawi H, Hussein H, Easty D (2001) Tear film MMP accumulation and corneal disease. Br J Ophthalmol 85(2):147–153.  https://doi.org/10.1136/bjo.85.2.147 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Wisse RP, Kuiper JJ, Gans R, Imhof S, Radstake TR, Van der Lelij A (2015) Cytokine expression in keratoconus and its corneal microenvironment: a systematic review. Ocul Surf 13(4):272–283.  https://doi.org/10.1016/j.jtos.2015.04.006 Epub 2015 Jul 30 CrossRefPubMedGoogle Scholar
  17. 17.
    Nishtala K, Pahuja N, Shetty R, Nuijts RMMA, Ghosh A (2016) Tear biomarkers for keratoconus. Eye Vis 3:19.  https://doi.org/10.1186/s40662-016-0051-9 CrossRefGoogle Scholar
  18. 18.
    Sorkhabi R, Ghorbanihaghjo A, Taheri N, Ahoor MH (2015) Tear film inflammatory mediators in patients with keratoconus. Int Ophthalmol 35:467.  https://doi.org/10.1007/s10792-014-9971-3 CrossRefPubMedGoogle Scholar
  19. 19.
    Pásztor D, Kolozsvári BL, Csutak A, Berta A, Hassan Z, Ujhelyi B, Gogolák P, Fodor M (2016) Tear mediators in corneal ectatic disorders. PLoS ONE 11(4):e0153186.  https://doi.org/10.1371/journal.pone.0153186 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Maguen E, Zorapapel NC, Zieske JD, Ninomiya Y, Sado Y, Kenney MC, Ljubimov AV (2002) Extracellular matrix and matrix metalloproteinase changes in human corneas after complicated laser-assisted in situ keratomileusis (LASIK). Cornea 21(1):95–100CrossRefPubMedGoogle Scholar
  21. 21.
    Ji H, Chen A, Zhang W, Gu H, Zhang Z, Fu J (2014) Dynamic changes of tear fluid matrix metralloproteinase-9 within 1 year after laser in situ keratomileusis. Nan Fang Yi Ke Da Xue Xue Bao 34(8):1079–1082PubMedGoogle Scholar
  22. 22.
    Maguen E, Rabinowitz YS, Regev L, Saghizadeh M, Sasaki T, Ljubimov AV (2008) Alterations of extracellular matrix components and proteinases in human corneal buttons with INTACS for post-laser in situ keratomileusis keratectasia and keratoconus. Cornea 27(5):565–573.  https://doi.org/10.1097/ICO.0b013e318165b1cd CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Mohamed Nagy Elmohamady
    • 1
  • Walid Abdelghaffar
    • 1
  • Tamer Ibrahim Salem
    • 1
  1. 1.Ophthalmology Department, Faculty of MedicineBenha UniversityBenhaEgypt

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