Dry eye 2

Abstract

A 22-year-old male becomes a LASIK candidate with a slightly asymmetric cornea with thinning of the epithelial layer in the center and normal biomechanics. Can we perform a LASIK procedure? The thinner layer of epithelium in the center is a warning sign of the risk of keratoconus. However, because the corneal stroma's collagen structure on the polarizing OCT and the values of the corneal biomechanics on the Corvis device were regular, it is possible to perform the laser refractive operation. To be sure, we preferred PRK to LASIK. The gene expression analysis was performed from the epithelium. It confirmed normal levels associated with collagen. Nevertheless, it also discovered significantly increased levels of matrix metallopeptidase 9 (MMP9) enzymes, and increased levels of the apoptosis regulator BAX and BCL lymphoma 2 (BCL2), a sign of inflammation. Therefore epithelial remodeling occurs in the patient. Decreased lysyl oxidase (LOX) levels are standard in keratoconus. We can perform PRK on an eye with suspected corneal topography, signs of inflammation, and normal biomechanice. It is then recommended to administer steroids at a decreasing dose and artificial tears for six months, cyclosporin A and tetracycline. Inflammatory enzymes can be examined in clinical practice with diagnostic kits of molecular markers of inflammation, which is essential for reducing the risk of postoperative complications.