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YS Yun, H Lew, WI Rhim, MS Kang, SG Hong; Measurement of pH, Electrolytes and Electrophoretic Studies of Tear proteins in Patients with Nasolacrimal duct obstruction . Invest. Ophthalmol. Vis. Sci. 2002;43(13):94.
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Purpose: To determine whether differences of tear constituents exist between normal persons and primary acquired nasolacrimal duct obstruction (PANDO) patients and to correlate the changes of tear composition with the degree of PANDO. Methods: We tested 30 normal persons (42.0 ± 21.4 years) and 34 PANDO patients (44.8 ± 17.9 years) consisting of 18 complete and 16 partial obstruction cases classified by the dacryocystographic findings. We measured the pH, the concentration of Na+, K+, Cl-, total calcium and total protein of the tear. The composition of tear protein was demonstrated by cellulose acetate electrophoresis. The data were statistically analyzed by t-test of the SAS program Results: The pH was more alkaline in patients with PANDO (7.11 ± 0.38), especially in complete obstruction cases (7.14 ± 0.30, p=0.047) compared with the normal persons (6.94 ± 0.35). The concentration of Na+, K+, Cl- and total protein were similar in normal and PANDO, while total calcium concentration was significantly higher in PANDO (2.62 ± 1.70 mg/dl) compared with the normal cases (1.73 ± 0.97mg/dl), (p=0.015). And this change was found in both complete obstruction cases (2.47 ± 1.25 mg/dl, p=0.027) and partial obstruction cases (3.00 ± 2.16 mg/dl, p=0.009). The proportion of the tear protein in fractions 1 to 4 were 35.4 ± 11.3%, 5.9 ± 3.9%, 37.9 ± 7.0% and 20.3 ± 7.7% in normal persons, while they were 28.1 ± 7.1% (p=0.006), 5.2 ± 3.8%, 38.9 ± 5.8% and 27.9 ± 6.2% (p=0.00) in PANDO patients. Similar changes of tear protein fractions 1 and 4 were observed in complete obstruction (28.1± 7.0%, p=0.006; 27.6 ± 6.0%, p=0.003) and in partial obstruction cases (27.4 ± 7.7%, p=0.026; 28.3 ± 6.5%, p=0.003). Conclusion: Tears in PANDO cases were more alkaline, higher in calcium concentration, and unstable in the proportion of tear proteins compared with normal persons. These results may provide better understanding of tear physiology and pathogenesis of the PANDO.
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