Proteomic analysis of tear fluid: Comparative short-term effects of scleral lenses and rigid corneal lenses wear in ametropic healthy adults.

Purpose: The aim of this study was to evaluate the effect of scleral lenses (SLs) on the ocular surface of healthy individuals and explore potential molecular changes in the tear fluid reservoir associated with this form of contact lens.

Methods: Forty-one healthy Chinese subjects were enrolled in the prospective study and assigned to wear SLs or rigid corneal lenses (RCL), and their ocular surface was evaluated at various time points over one month period. Hyperemia, tear film stability, and molecular changes in tear fluid were assessed. Tandem mass tagging proteomics analysis was used to identify differentially expressed proteins in tears after wearing different lenses.

Results: There were no statistically significant differences observed in in the hyperemia index of the nasal and temporal ciliary vessel areas, as well as the nasal and temporal conjunctival vessel areas between groups. The difference in tear film stability between the two groups was not statistically significant. However, proteomic analysis of tear samples revealed 397 differentially expressed proteins in the SLs group, including pro-inflammatory markers such as interleukins. Pathway analysis identified upregulation of inflammation-related pathways.

Conclusions: SLs wear does not significantly impact hyperemia and tear film stability compared to RCL. Nevertheless, at the molecular level, there is evidence showing an underlying inflammatory response. These findings require continued research to elucidate the clinical implications of these molecular changes and to guide SLs fitting.