title: Downward extension of the lacrimal gland under the bulbar conjunctiva after trabeculectomy.
abstract: OBJECTIVE
  To describe two cases in which the lacrimal gland was considered to extend downward under the bulbar conjuctiva following trabeculectomy.
  
  
  METHODS
  We report two patients who complained of epiphora after trabeculectomy. A biopsy was performed on the tissue under the bulbar conjunctiva on the periphery of the bleb of case 1. The anatomical relationship between the holes and the avascular filtering bleb in case 2 was investigated using ultrasound biomicroscopy.
  
  
  RESULTS
  In case 1, a biopsy showed the lacrimal gland tissue filtrated with mononuclear cells. In case 2, ultrasound biomicroscopy revealed no connection between the multiple leaking holes and localized filtering bleb.
  
  
  CONCLUSIONS
  Following trabeculectomy at the superior temporal quadrant, we should consider downward extension of the lacrimal gland as a possible source of a patient's complaint of epiphora.
authors.affiliation: Department of Ophthalmology, Jichi Medical School, Tochigi, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Kambara
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
authors.forename: M
authors.initials: M
authors.lastname: Hayashi
authors.forename: S
authors.initials: S
authors.lastname: Yamagami
mesh_terms: D000328:Adult; D003228:Conjunctiva / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery; D006801:Humans; D007765:Lacrimal Apparatus / Q000000981:diagnostic imaging / Q000473:pathology*; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014130:Trabeculectomy / Q000009:adverse effects*; D014463:Ultrasonography