Temporal analysis of tear fluid proteome reveals critical corneal repair events after photorefractive surgery

Corneal epithelial wound healing is a complex and finely orchestrated process critical for restoring visual acuity following injury or surgery. Photorefractive keratectomy (PRK), a common refractive surgical procedure, provides an ideal clinical model to study this process. Here, we employed advanced proteomic analysis to comprehensively map the dynamic changes in the tear fluid proteome at distinct phases following PRK. Our findings revealed significant alterations in nearly 45% of the tear proteome, highlighting temporally distinct molecular signatures. Immediately post-injury, a robust but controlled anti-inflammatory response coincided with pronounced upregulation of protein synthesis and cellular stress-management pathways. Subsequently, at day three, the molecular landscape shifted toward sustained epithelial regeneration, extracellular matrix remodeling, and controlled inflammation resolution. By delineating these critical and temporally compartmentalized molecular events, this study identifies novel tear-based biomarkers indicative of corneal healing efficacy and provides essential insights into potential therapeutic targets for improving clinical outcomes in corneal wound healing and ocular surface disorders.