title: The anatomical relationships between the lower eyelid retractors and the lacrimal caruncle: a microscopic study.
abstract: OBJECTIVE
  To characterize the microscopic relationships between the lower eyelid retractors and the lacrimal caruncle and to define the possible role of the caruncle in the lacrimal drainage process.
  
  
  METHODS
  Observational anatomic study.
  
  
  METHODS
  Twelve eyelids with their orbital tissues (6 right and 6 left), fixed in 10% buffered formalin, were studied in 10 Asian cadavers (mean age at death: 77.1 years, age range: 62-92 years). An oblique incision in the harvested tissue specimen passed through the lower eyelid retractors and the lacrimal caruncle. The sliced specimens were stained with Masson's trichrome.
  
  
  RESULTS
  In all specimens, the lower eyelid retractors were shown to have direct connections to the lacrimal caruncle at the level of the medial horn of the lower eyelid retractors and to reach the medial rectus capsulopalpebral fascia. At this level, smooth muscle fibers were abundant both in the lower eyelid retractors and in the medial rectus capsulopalpebral fascia, which were symmetrically situated to the caruncle.
  
  
  CONCLUSIONS
  The lower eyelid retractors have direct connections to the lacrimal caruncle, at a level that is rich in smooth muscle fibers. These anatomic findings may confer functional advantages to the lacrimal drainage system.
authors.affiliation: Department of Ophthalmology, Aichi Medical University, Aichi, Japan. cosme@d1.dion.ne.jp
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kakizaki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ikeda
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
authors.forename: Igal
authors.initials: I
authors.lastname: Leibovitch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000033:anatomy & histology*; D005143:Eyelids / Q000033:anatomy & histology*; D005152:Facial Muscles / Q000033:anatomy & histology; D005205:Fascia / Q000033:anatomy & histology; D006801:Humans; D007765:Lacrimal Apparatus / Q000033:anatomy & histology*; D008875:Middle Aged; D009130:Muscle, Smooth / Q000033:anatomy & histology*; D009801:Oculomotor Muscles / Q000033:anatomy & histology*