Another study to note by Smith and coworkers [32] showed a lack of increase of TIMP-1 in clear keratoconus corneas and yet an significant increase of TIMP-1 in scarred keratoconus corneas, and suggested that TIMP-1 may play a role in “curtailing keratoconus.” The results of our study seem to indicate that further testing is needed to verify the presence and function of TIMP-1 in tears in keratoconus patients. Here, TIMP1 is linked to keratoconus.