Tear secretion and lacrimal gland function of rabbits treated with isotretinoin

The aim of the present study was to report two cases of refractory dry eye syndrome (DES) after transconjunctival excision of the palpebral lobe of the lacrimal gland. A 25-year-old female patient with a chief complaint of a palpable mass in both upper eyelids visited our medical center. Preoperative orbital computer tomography showed high-attenuation lesions in both lacrimal glands. Incisional biopsy of the lacrimal gland palpebral lobe via transconjunctival incision was performed in January 2019. At 1 month after the biopsy, a lack of tears and persistent corneal erosions were found in both eyes. Artificial tears, punctal occlusion, autologous serum eye drops, and therapeutic contact lenses were applied in an attempt to control the dry eye symptoms. The patient continues to suffer from intractable DES at 2.5 years after the procedure. The second case involved a 52-year-old female patient who visited our medical center with a chief complaint of a palpable mass in both upper eyelids. Bilateral orbital tumors were diagnosed with preoperative magnetic resonance imaging. An incisional biopsy of the lacrimal gland was performed. Immunoglobulin G4-related dacryoadenitis was confirmed through lacrimal palpebral lobe incisional biopsy. Intractable DES and corneal erosion of her left eye persisted thereafter. A transconjunctival incision is an effective approach for minimizing postoperative scars and is suitable for the biopsy of tumors that are visible through the conjunctiva. After a biopsy of the palpebral lobe of the main lacrimal glands, the secretion of reflex tears decreases due to damage to the secreting ducts of the main lacrimal glands. However, total tear secretion can be maintained by basal tear secretion from the accessory lacrimal glands. In this report, we describe two cases of refractory DES due to decreased total tear secretion, although only the palpebral lobes of the main lacrimal glands were biopsied.

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Direct visualization of aqueous tear secretion from lacrimal gland

Acta Ophthalmologica ◽

10.1111/aos.13335 ◽

2016 ◽

Vol 95 (4) ◽

pp. e314-e322 ◽

Cited By ~ 6

Author(s):

Eun Chul Kim ◽

Sang Hee Doh ◽

Se Yoon Chung ◽

Sam Young Yoon ◽

Man Soo Kim ◽

...

Keyword(s):

Lacrimal Gland ◽

Direct Visualization ◽

Tear Secretion

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Tear secretion from the lacrimal gland: variations in normal versus dry eyes

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318159 ◽

2021 ◽

pp. bjophthalmol-2020-318159

Author(s):

Swati Singh ◽

Swapna S Shanbhag ◽

Sayan Basu

Keyword(s):

Dry Eye ◽

Flow Rate ◽

Lacrimal Gland ◽

Healthy Subjects ◽

Time Lag ◽

Similar Time ◽

Dry Eyes ◽

Tear Secretion ◽

Direct Assessment ◽

Tear Flow

PurposeTo investigate the secretory status of the main lacrimal gland in healthy and dry eye disease (DED) via fluorescein-assisted direct assessment of tear secretion from the palpebral lobes.MethodsIncluded were 25 healthy subjects (50 lobes) and 75 subjects with DED (cicatrising conjunctivitis (CC, n=27), evaporative dry eyes (EDE, n=25) and Sjogren’s syndrome (SS, n=23)). Analysed parameters included number and location of ductular openings, tear flow rate per gland and per ductule, and the time lag for the initiation of secretion.ResultsDuctular openings could be observed in all patients with EDE and healthy subjects whereas only 33% (18/54) glands of CC patients and 67% glands (31/46) patients with SS revealed ductules. The median number of ductules per lobe was 4 in normal (range 3–5), 3 in EDE (3–6), 1 in SS (0–3) and 0 in CC group (0–3) (p<0.000001). The median tear flow rate per lobe in CC (0.00 μL/min) and SS (0.21 μL/min) was significantly lesser than normal lobes (1.05 μL/min, and EDE (0.99 μL/min eyes. The tear flow rate differed significantly between SS and CC group (p<0.0001). The maximum time lag occurred in the CC group (median, 20 s), followed by the SS group (median, 1.5 s) whereas the EDE group had similar time lag (<1 s) as of normal glands (p<0.0001).ConclusionDirect assessment of tear secretion from the palpebral lobe demonstrates significant differences between EDE, aqueous deficient dry eye and dry eye in CC.

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