PONE-D-19-34984

Altered mucins and aquaporins indicate dry eye outcome in patients undergoing Vitreo-retinal surgery

PLOS ONE

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Reviewer #1: Partly

Reviewer #2: Partly

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: No

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5. Review Comments to the Author

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Reviewer #1: Dry eye disease (DED) is clearly a multifactorial condition yet it is wholly a clinical diagnosis The tolerance of a given individual to the studied molecular changes may or may not be harbingers of future DED. The incorporation of DM patients, those undergoing retina detachment procedures and the newer trans conjunctival vitrectomy procedures in a single opus is confusing. Each cohort should be treated separately. The use of topical steroids postoperatively was not discussed. Were there significant variations in administration or was a single protocol utilized.

Reviewer #2: This is an interesting article relating the occurrence of Dry eye syndrome after vitrectomy. The methods performed in this manuscript are accurate and reasonable. All the conditions for inclusion and exclusion are done correctly. However the conclusions made in this article seem a little over-reaching. While it is true that multiple case studies have shown the occurrence of DES with vitrectomy, the results from this study do not seem to be as conclusive as one would like to see.

The pros of this manuscript are the recommendations made to Diabetic patients. It is also very interesting to see that mucin secretion and GCD go down significantly after the surgical procedure. The cons include low and under-explanation of the results and almost complete absence of discussion of the results. I would recommend the authors to reconsider how they portray the results better in an intelligible fashion. Also I do not understand the purpose of Figure 4. It is neither very informative nor self explanatory nor the authors have even attempted to explain whats going on in this figure. I would infact recommend the complete removal of this figure unless a better explanation is made.

Another question I had about the article is whether cytokines are elevated after any ocular surgery? Does any surgery cause cytokine increase or does this particular surgery casue it? May be some information regarding this in the discussion section can carve out a better explanation about the particular vitrectomy as a responsible factor for DES.

The authors may also consider explaining the acronyms for the genes better in the manuscript. This would increase the readability of the paper.

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Reviewer #1: No

Reviewer #2: No

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Altered mucins and aquaporins indicate dry eye outcome in patients undergoing Vitreo-retinal surgery

PONE-D-19-34984R1

Dear Dr. Angayarkanni,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

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With kind regards,

Deepak Shukla

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: All concerns have been addressed. This article is now suitable for publication in the current journal.

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Reviewer #1: No

Reviewer #2: No