title: Goblet cell response after photorefractive keratectomy and laser in situ keratomileusis.
abstract: To determine whether patients without dry eye preoperatively have an altered conjunctival goblet cell density and mucin secretion postoperatively and to explore what factors affect changes in goblet cell density and mucin secretion.
  
  
  
  The former Walter Reed Army Medical Center, Washington, DC, USA.
  
  
  
  Prospective nonrandomized clinical study.
  
  
  
  Impression cytology was used to determine conjunctival goblet cell density before and 1 week, 1 month, and 3 months after photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK). The McMonnies questionnaire, Schirmer test, tear breakup time, corneal sensitivity, rose bengal staining, and computerized videokeratoscopy were also performed to assess tear-film and ocular-surface health.
  
  
  
  The ratio of goblet cell to total cells changed postoperatively from baseline in both groups (P < .001). The most significant change was a median 29% decrease 1 month postoperatively. However, there were no significant differences between groups over time (P = .772). The ratio of filled goblet cell to total goblet cell did not change significantly over the same time period (P = .128), and there were no significant differences between the PRK group and the LASIK group over time (P = .282).
  
  
  
  Patients without apparent dry eye had an altered conjunctival goblet cell population after PRK or LASIK. The conjunctival goblet cell population tended to decrease in the early postoperative period after either surgery and was most affected by preoperative goblet cell density. The changes in the tear film and ocular surface did not seem to affect goblet cell mucin secretion after either procedure.
  
  
  
  None of the authors has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Warfighter Refractive Eye Surgery Program and Research Center (Ryan, Sia), Fort Belvoir, Virginia, the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, and the Ophthalmology Service (Stutzman) and the Biostatistics Section (Howard), Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, the Schepens Eye Research Institute (Shatos, Dartt), Harvard University, Boston, Massachusetts, and the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, USA. Electronic address: denise.s.ryan.ctr@mail.mil.
authors.forename: Denise S
authors.initials: DS
authors.lastname: Ryan
authors.affiliation: From the Warfighter Refractive Eye Surgery Program and Research Center (Ryan, Sia), Fort Belvoir, Virginia, the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, and the Ophthalmology Service (Stutzman) and the Biostatistics Section (Howard), Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, the Schepens Eye Research Institute (Shatos, Dartt), Harvard University, Boston, Massachusetts, and the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Kraig S
authors.initials: KS
authors.lastname: Bower
authors.affiliation: From the Warfighter Refractive Eye Surgery Program and Research Center (Ryan, Sia), Fort Belvoir, Virginia, the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, and the Ophthalmology Service (Stutzman) and the Biostatistics Section (Howard), Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, the Schepens Eye Research Institute (Shatos, Dartt), Harvard University, Boston, Massachusetts, and the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Rose K
authors.initials: RK
authors.lastname: Sia
authors.affiliation: From the Warfighter Refractive Eye Surgery Program and Research Center (Ryan, Sia), Fort Belvoir, Virginia, the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, and the Ophthalmology Service (Stutzman) and the Biostatistics Section (Howard), Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, the Schepens Eye Research Institute (Shatos, Dartt), Harvard University, Boston, Massachusetts, and the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Marie A
authors.initials: MA
authors.lastname: Shatos
authors.affiliation: From the Warfighter Refractive Eye Surgery Program and Research Center (Ryan, Sia), Fort Belvoir, Virginia, the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, and the Ophthalmology Service (Stutzman) and the Biostatistics Section (Howard), Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, the Schepens Eye Research Institute (Shatos, Dartt), Harvard University, Boston, Massachusetts, and the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Robin S
authors.initials: RS
authors.lastname: Howard
authors.affiliation: From the Warfighter Refractive Eye Surgery Program and Research Center (Ryan, Sia), Fort Belvoir, Virginia, the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, and the Ophthalmology Service (Stutzman) and the Biostatistics Section (Howard), Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, the Schepens Eye Research Institute (Shatos, Dartt), Harvard University, Boston, Massachusetts, and the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mines
authors.affiliation: From the Warfighter Refractive Eye Surgery Program and Research Center (Ryan, Sia), Fort Belvoir, Virginia, the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, and the Ophthalmology Service (Stutzman) and the Biostatistics Section (Howard), Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, the Schepens Eye Research Institute (Shatos, Dartt), Harvard University, Boston, Massachusetts, and the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Stutzman
authors.affiliation: From the Warfighter Refractive Eye Surgery Program and Research Center (Ryan, Sia), Fort Belvoir, Virginia, the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, and the Ophthalmology Service (Stutzman) and the Biostatistics Section (Howard), Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, the Schepens Eye Research Institute (Shatos, Dartt), Harvard University, Boston, Massachusetts, and the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Darlene A
authors.initials: DA
authors.lastname: Dartt
mesh_terms: D003315:Cornea; D015352:Dry Eye Syndromes; D020397:Goblet Cells / Q000502:physiology*; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D009216:Myopia; D018903:Photorefractive Keratectomy; D011446:Prospective Studies