LAUSR

PURPOSE To investigate the mechanisms of pathological changes in corneal stroma and the wearing time of soft contact lenses using the metabolomic method. METHODS Laser scanning confocal microscopy was used to evaluate the pathological changes of corneal stroma between wearing time groups before small incision lenticule extraction. After small incision lenticule extraction, 190 corneal stroma samples were obtained, and a metabolomic method using high performance liquid chromatography coupled with time of flight mass spectrometry was established to analyze the changes in metabolites between wearing time groups. RESULTS Laser scanning confocal microscope results demonstrated that the corneal nerve fiber length, the number of corneal anterior stromal cells, and the number of corneal posterior stromal cells were reduced gradually with increasing wearing time. The metabolomic study demonstrated that 11 biomarkers were identified between patients who did and did not wear soft contact lenses and 6 biomarkers were identified between less than 5 years and more than 5 years of wearing time. These biomarkers participate in energy metabolism, lipid metabolism, inflammatory reactions, and neuroprotecton processes, and partially lead to the pathology of dry eyes, eye inflammation, and corneal nerve fiber length decrease. Five biomarkers in the citrate cycle metabolism pathway were found demonstrating that energy metabolism was seriously disturbed. CONCLUSIONS This study systematically revealed the metabolite mechanism for eye discomfort and related disease after wearing soft contact lenses. The identified biomarkers and related physiology pathways supply a new direction for avoiding the side effects of wearing soft contact lenses. [J Refract Surg. 2020;36(5):317-325.].