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Sara Plazola, Melissa Flores, Alejandra Guzman; Ultrasonic Biomicroscopy as a complementary tool for the evaluation of diseases of the lacrimal drainage system. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3571. doi: https://doi.org/.
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To prove that the ultrasonic biomicroscopy is a new tool for the evaluation of diseases of the lacrimal drainage system.
We used a 35 MHz immersion probe (Optikon) and the Ultrasonic Biomicroscope HiScan (Optikon). Over the probe we used a Rolled Probe Cover with 10 ml of sterile solution. We used and immersion technique with the patient lying down. We added topical anesthesia to the eye and asked the patient to close his/her eyes. We added hypromellose over the eyelids if necessary.
All of the patients were comfortable during the study with no signs of pain.The 35 MHz probe was the best compared to the 50 MHz probe. The probe must be localized perpendicular to the structure we want to study. We were able to identify the canaliculi, the common canaliculus and the lacrimal sac. We evaluated patients with dacryocystorhinostomy (endoscopic and external), conjuntivodacryocystorhinostomy, closed dacryointubation, with or without silicon tube, acute and chronic dacryocystitis, fistula, low obstruction and congenital malformations. In all cases we obtained good quality and objective images. In patients with silicon tube it was easier to identify de canaliculi and the tube was seen in the sac as high reflectivity lines. Dilatated lacrimal sacs where also easier to identify than normal sacs or sacs without dilatation. Structures with acute or chronic inflammation sometimes showed high reflectivity walls or showed as diffuse structures. In patients with lacrimal sac fistulas we where able to observe the connection of the sac to the skin. Also the connection of the Jones tube was visible. The symptoms and signs referred by the patient at the moment of the study where related to the findings seen by ultrasonic biomicroscopy
The ultrasonic biomicroscopy is useful for obtaining good quality images of the canaliculi, common canaliculus and lacrimal sac. The exploration was comfortable for the patient. The ultrasonic biomicroscopy is a new helpful tool for the evaluation of the lacrimal drainage system and its diseases.
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