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Evaluation of Lacrimal Tear Drainage Mechanism Using Dynamic Fluoroscopic Dacryocystography

Lee, Min Joung M.D.*; Kyung, Hak Su M.D.*; Han, Moon Hee M.D.; Choung, Ho-Kyung M.D.; Kim, Nam Ju M.D.§; Khwarg, Sang In M.D.*

Ophthalmic Plastic & Reconstructive Surgery: May-June 2011 - Volume 27 - Issue 3 - p 164-167
doi: 10.1097/IOP.0b013e3181f0b4cc
Original Investigations
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Purpose: To evaluate the dynamic change of the canaliculus and the lacrimal sac during blinking using fluoroscopic dacryocystography.

Methods: Sixteen patients presenting with unilateral epiphora were enrolled in the study. Fluoroscopic dacryocystography was performed in both eyes, and sequential images of the lacrimal drainage system were acquired during blinking. On examination of the contralateral asymptomatic side, the length of the lower canaliculus and the width of the superior and inferior portions of the lacrimal sac were measured and compared between eyelid closure and opening.

Results: The length of the lower canaliculus decreased with eyelid closure in 13 of 16 patients, and the change was statistically significant (p = 0.006, Wilcoxon signed rank test). The width of the superior portion of the lacrimal sac increased with eyelid closure (p = 0.033), but the width of the inferior part did not change significantly (p = 0.679).

Conclusions: With eyelid closure, the canalicular system contracts, and the superior portion of the lacrimal sac dilates; these may be important parts of the active lacrimal pump mechanism. These findings suggested that the canalicular system and the superior portion of the lacrimal sac play key roles in active tear drainage pump.

The length of the lower canaliculus and the width of the superior portion of the lacrimal sac significantly change when blinking as measured using fluoroscopic dacryocystography.

Departments of *Ophthalmology and †Radiology, Seoul National University Hospital; ‡Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul; and §Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea

Accepted for publication July 5, 2010.

Presented at the 40th Annual Fall Meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery, October 22, 2009, San Francisco, CA, U.S.A.

The authors do not have any proprietary interests or conflict of interest with respect to any equipment or products mentioned in the article.

Address correspondence and reprint requests to Sang In Khwarg, M.D., Department of Ophthalmology, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, Korea. E-mail: khwarg@snu.ac.kr

©2011The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.