The Mechanism Of Cyclosporine A On Tear Film After LASIK

Objective:To study the influence of clinical and the effects of CyclosporineA (CsA) to tear secretion,tear film of postoperative molecular laser corneal in-situgrinding with surgery (LASIK),further explore the mechanism which the effect ofCsA improve the dry eyes after LASIK.The test will provide a new theoreticalbasis.Methods:Select120eyes of60LASIK surgery patients in the center ofophthalmic excimer treatment of The General Hospital of Ningxia MedicalUniversity from October2012to September2013. Postoperative1week,150eyes(75patients) appear abnormal tear film.Randomly divided them intoⅠ group(CsA) and27patients(54eyes), Ⅱ group (group of artificial tears) and25patients(50eyes),Ⅲ group (regular control group) and23patients(46eyes).Ⅰgroup (CsA): postoperative1week, to be0.05%CsA eye drops,2times/d,stoppostoperative3m.Ⅱ group (group of artificial tears): postoperative1week,to becarbomer eye ophthalmic gel,4times/d,stop postoperative3m. Ⅲ group(regularcontrol group):to be regular medication.Comparative observation of tearsecretion,tear breakup time of patients of the3groups in preoperative andpostoperative1week,1month,3months;for pathological observation ofconjunctival goblet cell damage and recovery; observation the changes ofEFG,TGF-β1and IL-1β in tears by ELISA.The results were statistically analyzed.Results:(1)1week:there was not significant differences between three groupin tear secretion increased,tear breakup time prolonged,conjunctival epithelialsquamous metaplasia alleviated,goblet cells increased,EGF,TGF-β1,IL-1β(p>0.05).(2)BUT:1m,3m, Ⅰ group were higher thanⅡ group,Ⅲ group,and that of Ⅰ group at1w(p<0.05).Ⅰ group was flat withpreoperative(p>0.05).Ⅰ group andⅡ group were higher than Ⅲ group(p<0.05).(3)SIt:1m,3m,Ⅰ group were higher than Ⅱ group,Ⅲ group,and that of Ⅰ group at1w(p<0.05).Ⅰ group was flat with preoperative(p>0.05).Ⅰ group andⅡ group werehigher than Ⅲ group(p<0.05).(4)Conjunctival epithelial squamousmetaplasia:1m,3m, Ⅰ group were lighter than Ⅱ group, Ⅲ group,and that of Ⅰgroup at1w(p<0.05).1m,there was not difference between Ⅱ group,Ⅲ group.3m,Ⅱgroup was lighter than Ⅲgroup.(5)Oblet cells:1m,3m,Ⅰgroup were more thanⅡgroup,Ⅲgroup,and that of Ⅰgroup at1w(p<0.05).1m,3m,Ⅱgroup was morethan Ⅲ group.(6)EGF:1m,3m,Ⅰ group were higher than Ⅱ group,Ⅲ group,and thatof Ⅰ group at1w(p<0.05).1m,3m, Ⅱ group was higher than Ⅲgroup.(7)TGF-β1:1m,3m,Ⅰ group were higher than Ⅱ group,Ⅲ group,and that ofⅠgroup at1w(p<0.05).1m,3m,Ⅱgroup was higher than Ⅲgroup.(8)IL-1β:1m,3m,Ⅰ group were below than Ⅱ group, Ⅲ group,and that of Ⅰ group at1w(p<0.05).1m,there was not difference between Ⅱ group,Ⅲ group.3m,Ⅱ groupwas below than Ⅲ group.Conclusion:(1) In the early stage after LASIK,the tear film break-up timeshorter,tear secretion decreased,abnormal grade of conjunctival squamousmetaplasia,and so on,further tear film stability decline.(2)0.05%CsA eye dropshad obvious effect for dry eyes after LASIK.The mechanism of treatment was maybe increase the number of goblet cells,EGF,TGF-β1,reduce IL-1β,therebyinhibiting the inflammation of ocular surface,and relieving inflammation cellsinfiltration.The artificial tears was weaker than0.05%CsA.(3)The researchprovides a new drugs way for treatment tear film stability of dry eyes after LASIK.