Videoreflective dacryomeniscometry in normal adults and in patients with functional or primary acquired nasolacrimal duct obstruction.
OBJECTIVE
Videoreflective dacryomeniscometry (VRD) for evaluation of marginal tear film has not been performed in patients with watery eye or in a controlled study. We used VRD to evaluate the height of the central marginal lower lid tear film in normal adults and compared it with two watery-eye groups and a postoperative dacryocystorhinostomy (DCR) group.


METHODS
Case-controlled interventional case series.


METHODS
We evaluated with VRD 20 subjects with normal lacrimal drainage function, 21 patients with primary acquired nasolacrimal duct obstruction (PANDO), 28 patients with functional nasolacrimal duct obstruction (FNLDO), and a postoperative group of 14 patients derived from the previous two pathologic groups. Comparison between the four groups was performed to determine statistically significant differences between tear film height.


RESULTS
PANDO and FNLDO groups were shown to have significantly greater median tear meniscus heights ([TMH] PANDO: 620 microm, interquartile range [IQR] 453 microm; FNLDO: 731 microm, IQR 529 microm) than normal subjects (296 microm, IQR 214 microm; P < .001) and postoperative PANDO patients (265 microm, IQR 159 microm). There was no significant difference in TMH between PANDO and FNLDO groups preoperatively (P = .275). There was a reduction in median TMH postoperatively of 355 microm (P = .008) in PANDO and 360 microm (P = .068) in FNLDO.


CONCLUSIONS
PANDO and FNLDO patients have similar preoperative TMH. In both these groups, TMH is significantly greater than in normal control subjects. Lacrimal drainage surgery substantially reduces TMH as measured using VRD in PANDO.
Francis
Ian C
IC
Ocular Plastics Unit, Prince of Wales Hospital, Randwick, Australia. if@student.unsw.edu.au
Chan
Derek G
DG
Papalkar
Daya
D
Papas
Eric B
EB
Stapleton
Fiona
F
D000368:Aged; D016022:Case-Control Studies; D003608:Dacryocystorhinostomy; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D009301:Nasolacrimal Duct / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D010781:Photography; D013666:Tears / Q000502:physiology*; D014741:Video Recording