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Paola Brito Sandoval; Using ultrasound biomicroscopy in evaluation of lacrimal drainage obstruction: a preliminary study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4827.
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© ARVO (1962-2015); The Authors (2016-present)
The ultrasound biomicroscopy (UBM) is a high resolution imaging study. The lacrimal system is an accessible structure through the skin and contains liquid which makes it ideal for the realization of UBM. Never the less its use to evaluate this structure has not been widespread. We performed an observational and comparative study to evaluate each structure in the lacrimal drainage system with UBM, its normal measurements and compared them with patients with lacrimal obstruction.
UBM was performed in healthy subjects and patients with lacrimal obstruction, adults, above 18 years old. As a immersión container we used modified swimming goggles. We used a VuMAX, Sonomed UBM with the 35mHz probe.
We evaluated 18 patients, 12 controls and 6 cases of lacrimal obstruction. Controls: we identified the following structures and its measurements: canaliculi with an mean diameter of 0.71 mm, common canaliculus 1.23 mm and lacrimal sac 3.43 mm. Cases: there were 2 cases of upper lacrimal obstruction, 2 cases of lower lacrimal obstruction and 2 cases that had dacryointubation surgery performed. Measurements: canaliculi with a mean diameter of 0.62mm, common canaliculus 1.07mm and tear sac 3.58mm. The was no diference in the diameters between the cases and controls. We compared between male and female and we did found a diference.Female/MaleTear Sac: 2.87mm/ 4.26mmCommon canaliculus: 0.95mm/ 1.33mmSuperior and inferior canaliculus: 0.64mm/ 0.72mmThe patients with dacryointubation surgery, we didnt visualize the silicone probe inside the canaliculi or sac, due to the attenuation of the sound waves and the lumen is not empty or hypoechoic as in controls.Other findings: One of the patients didnt have a common canaliculus, another had a bifurcation of the naso-lacrimal duct. All had prominent mucosal folds and valves narrowing the lumen and debris in the lumen. We visualized the angular vessels.
We were able to observe the diferent parts of the lacrimal drainage. We observed no difference in the diameters between the groups, but we did when we compared the females with males. The study was tolerated, causing minimal discomfort. There was a slight leak of liquid due to the sealing of the goggles. In conclusion, UBM is a useful, easily accessible, low cost and noninvasive tool to evaluate eyelid and lacrimal structures, with no complications.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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