The Impact of TGF-β on Corneal Stromal Remodeling After LASIK and PRK

Abstract

Laser refractive surgery- encompassing both LASIK (Laser-Assisted in Situ Keratomileusis) and PRK (Photorefractive Keratectomy) - represents one of the most widely performed elective procedures for correcting refractive errors worldwide. The wound healing response following these interventions involves intricate molecular cascades, with transforming growth factor-beta (TGF-β) playing a pivotal regulatory role in stromal remodeling. This cytokine orchestrates the transformation of quiescent keratocytes into contractile myofibroblasts, modulates extracellular matrix synthesis, and influences the development of corneal haze-a complication that can compromise visual outcomes. The present review examines the mechanistic underpinnings of TGF-β action in corneal wound healing, compares the differential stromal responses between LASIK and PRK, and analyzes the clinical implications of these processes. Understanding TGF- β-mediated pathways provides a foundation for developing targeted therapeutic strategies aimed at minimizing fibrotic responses and optimizing clinical outcomes following refractive surgery. By elucidating the molecular distinctions between these two surgical approaches, we can better predict healing trajectories and tailor interventions to individual patient needs.