title: Tear lipid layer interference changes after dacryocystorhinostomy.
abstract: OBJECTIVE
  Specular images of the tear film in the central cornea were examined in patients with nasolacrimal duct obstruction to observe changes before and after dacryocystorhinostomy (DCR).
  
  
  METHODS
  We observed the specular images in 4 patients (5 eyes) by a noncontact observation device and recording system. Observed patterns were classified into five grades. The specular images and tear meniscus height (TMH) were recorded.
  
  
  RESULTS
  Three of the 4 eyes with TMH values over 0.4 mm before DCR showed decreased TMH postoperatively. The 1 eye with a TMH value of 0.2 mm showed no change after DCR. Using specular images, 4 eyes were classified grade 1 or 2, and 1 eye was classified grade 4 before DCR. After DCR, the 5 eyes were classified as grade 3 or grade 4.
  
  
  CONCLUSIONS
  The results indicated that the eye after DCR has a thicker lipid layer than the eye before DCR.
authors.affiliation: Department of Ophthalmology, Hirosaki University School of Medicine, Hirosaki, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kubo
authors.forename: T
authors.initials: T
authors.lastname: Sakuraba
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: M
authors.initials: M
authors.lastname: Nakazawa
mesh_terms: D000368:Aged; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000378:metabolism*; D050356:Lipid Metabolism; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000378:metabolism* / Q000601:surgery; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism*