{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:06:27Z","timestamp":1784113587816,"version":"3.55.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study is to investigate the microbial and proteomic features of the ocular surface following small incision lenticule extraction (SMILE) surgery and to elucidate their association with the development of postoperative dry eye disease (DED).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study comprised a prospective cohort for baseline assessment and a cross-sectional postoperative assessment. We enrolled two sets of participants: a preoperative cohort (PG) consisting of patients scheduled for SMILE; and a postoperative cohort,consisting of patients who had undergone SMILE. The postoperative cohort was further categorized into non-dry eye group (NDEG) and dry eye group (DEG) groups based on examination. Conjunctival swabs and tear samples were collected for 16S rRNA gene sequencing (V3-V4 region) and label-free quantitative proteomics, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 52 subjects were included. Microbiome analysis revealed significantly lower \u03b1-diversity (Chao1, Shannon) in the DEG than in the PG and\/or NDEG (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). \u03b2-diversity analysis showed significant structural differences between the DEG and both the PG and NDEG. Staphylococcus and Corynebacterium were enriched in the DEG, while commensals such as Clostridia and Bacteroidota showed higher relative abundances in the NDEG. DEG exhibited specific activation of stress pathways (NF-\u03baB signaling, macroautophagy) and a bidirectional dysregulation of the coagulation-complement system, a pattern suggestive of a potential \u201cthromboinflammation\u201d-like state. Weighted gene co-expression network analysis delineated three axes: an overactive \u201cMetabolism-Stress Axis\u201d, and impaired \u201cHomeostatic Regulation Axis\u201d and \u201cOrderly Repair Axis\u201d in the DEG.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cross-sectional analysis, the presence of DED after SMILE is associated with a distinct shift in the ocular surface microbiome towards a pro-inflammatory state and a concomitant breakdown of host proteomic homeostasis. The observed correlation between microbial dysbiosis and dysregulation of host pathways, particularly the coagulation-complement system, suggests a potential integrated mechanism for postoperative dry eye. These findings identify candidate biomarkers for risk prediction and new therapeutic targets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1858069","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:31:21Z","timestamp":1784111481000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated microbiomic and proteomic profiling reveals distinct ocular surface molecular and microbial landscapes in dry eye after SMILE surgery"],"prefix":"10.3389","volume":"16","author":[{"given":"Li","family":"Zhang","sequence":"first","affiliation":[{"name":"Shanxi Medical University","place":["Taiyuan, China"]},{"name":"Shanxi Eye Hospital Affiliated to Shanxi Medical University","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Chen","sequence":"additional","affiliation":[{"name":"Shanxi Aier Eye Hospital (Shanxi)","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengfei","family":"Han","sequence":"additional","affiliation":[{"name":"Shanxi Aier Eye Hospital (Shanxi)","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huizhe","family":"Fu","sequence":"additional","affiliation":[{"name":"Shanxi Aier Eye Hospital (Shanxi)","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Sun","sequence":"additional","affiliation":[{"name":"Shanxi Eye Hospital Affiliated to Shanxi Medical University","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"B14","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.jtos.2020.09.003","article-title":"Ocular surface microbiota in patients with aqueous tear-deficient dry eye","volume":"19","author":"Andersson","year":"2021","journal-title":"Ocul. 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