Ascorbic acid levels in human tears after photorefractive keratectomy, transepithelial photorefractive keratectomy, and laser in situ keratomileusis

Purpose: To investigate the level of ascorbic acid in human tear fluid after photorefractive keratectomy (PRK), transepithelial PRK, and laser in situ keratomileusis (LASIK). Setting: Departments of Ophthalmology and Biochemistry, School of Medicine, Gazi University, Ankara, Turkey. Methods: Twenty patients (7 women and 13 men) were included in this study. Traditional PRK with epithelial scraping by a blunt spatula followed by surface ablation (7 eyes), transepithelial PRK (7 eyes), or LASIK (6 eyes) was performed. Tears were collected preoperatively and 1 and 5 days postoperatively, Ascorbic acid levels were measured using 2-4 dinitrophenylhydrazine. Results: Ascorbic acid levels in the tear fluid were decreased significantly 1 day after PRK, 'transepithelial PRK, and LASIK (P <.05). On the fifth day, the ascorbic acid levels were significantly lower than preoperatively in all groups. Conclusion: After PRK, transepithelial PRK, and LASIK, the ascorbic acid levels of the tear fluid decreased significantly. Because ascorbic acid is the major scavenger of superoxide radicals in tears, topical ascorbic acid therapy may help eliminate the harmful effect of free radicals from excimer laser surgery.