Tear production after unilateral removal of the main lacrimal gland in squirrel monkeys.
Tear production after unilateral removal of the main lacrimal gland in squirrel monkeys.
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DOI：
10.1001/archopht.118.2.246
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发表时间：
2000-02
影响因子：
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通讯作者：
D. Maitchouk;R. Beuerman;Toshihiko Ohta;Michael E. Stern;R. Varnell
中科院分区：
文献类型：
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作者：
D. Maitchouk;R. Beuerman;Toshihiko Ohta;Michael E. Stern;R. Varnell
目的研究摘除松鼠猴泪腺对基础泪液、反射泪液及眼表的影响。方法取6只单侧主泪腺摘除的松鼠猴，行泪液分泌试验、裂隙灯荧光染色，收集基础泪液和反射性（刺激性）泪液，分析0 ~ 20 kd泪液蛋白谱，并进行组织学评价。结果Schirmer试验结果显示，与对侧对照侧相比，术后1周基础泪液减少80%，反射泪液减少90%，术后20周分别减少32.2%和33.3%。然而，在6只猴中的5只中未观察到大体异常或荧光素染色，结膜表面保持正常。主泪腺和副泪腺分泌的蛋白质类型相似。术后20周角膜、结膜或眼睑组织未见组织学变化。结论：副泪腺分泌的泪液足以在角膜上维持稳定的泪液层，这表明所谓的基础泪液流量由主泪腺和副泪腺分泌的液体组成，主泪腺分泌的泪液减少不是干燥性角膜结膜炎的致病因素。临床相关性本研究表明，完全切除主泪腺本身不会导致干燥性角结膜炎。然而，附属腺的神经控制的性质尚不清楚。
OBJECTIVE To study the effects of lacrimal gland removal on basal and reflex tear production and on the ocular surface in the squirrel monkey. METHODS Unilateral main lacrimal gland removal in 6 squirrel monkeys was followed by Schirmer testing, slit-lamp examination with fluorescein, and collection of basal and reflex (stimulated) tears for analysis of tear protein spectra between 0 and 20 kd, as well as histological evaluation. RESULTS Schirmer test results showed an 80% decrease in basal tears and a 90% decrease in reflex tears during week 1, and a 32.2% and 33.3% decrease, respectively, at week 20 after surgery, compared with the contralateral control side. However, no gross abnormalities or fluorescein staining were seen in 5 of the 6 monkeys, and the conjunctival surfaces remained normal. The main and accessory lacrimal glands appeared to secrete similar types of proteins. No histological changes were seen in corneal, conjunctival, or eyelid tissues 20 weeks after surgery. CONCLUSIONS Tears from accessory lacrimal glands were sufficient to maintain a stable tear layer on the cornea, suggesting that so-called basal tear flow is made up of fluid from both main and accessory lacrimal glands and that decreased tear production by the main lacrimal gland is not a causative factor in keratoconjunctivitis sicca. CLINICAL RELEVANCE This study shows that total removal of the main lacrimal gland does not in itself lead to keratoconjunctivitis sicca. However, the nature of neural control of the accessory glands is not yet clear.