Electrolytes and Electrophoretic Studies of Tear Proteins in Tears of Patients with Nasolacrimal Duct Obstruction

Abstract

This study was performed to determine whether there are differences in tear constituents between normal persons and patients with primary acquired nasolacrimal duct obstruction (PANDO) and to correlate differences in tear composition with the degree of PANDO. We tested 30 normal persons (mean age 42.0 ± 21.4 years) and 34 PANDO patients (mean age 44.8 ± 17.9 years) consisting of 18 cases with complete obstruction and 16 cases with partial obstruction. We measured the pH, the concentration of Na⁺, K⁺, Cl^–, total calcium and total protein of the tears. The composition of tear protein was assessed by cellulose acetate electrophoresis. The data were analyzed by a t test. The pH was more alkaline in patients with PANDO (7.11 ± 0.38), especially in cases with complete obstruction (7.14 ± 0.30, p = 0.47) compared with the normal persons (6.94 ± 0.35). The concentration of Na⁺, K⁺, Cl^– and total protein were similar in normal and PANDO cases, while total calcium concentration was significantly higher in PANDO (2.62 ± 1.70 mg/dl) compared with the normal cases (1.73 ± 0.97 mg/dl), (p = 0.015). This change was found in both cases with complete obstruction (2.47 ± 1.25 mg/dl, p = 0.027) and cases with partial obstruction (3.00 ± 2.16 mg/dl, p = 0.009). PANDO patients had lower levels of tear protein fraction (TPF) 1 (p = 0.006) and higher levels of tear TPF 4 (p = 0.000) than normal persons. 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 improve our understanding of tear physiology and the pathogenesis of PANDO.

Evaluation of Tear Film Lipid Layer Thickness Measurements Obtained Using an Ocular Surface Interferometer in Nasolacrimal Duct Obstruction Patients

“…According to previous studies, tear protein components in patients are more alkaline, higher in calcium concentrations and inflammatory cytokines, and unstable compared with normal persons [78]. Kubo et al [9] reported that the tear lipid layer was thicker after dacryocystorhinostomy in four patients (five eyes).…”

“…Some research has investigated the components of tears in patients with nasolacrimal duct obstruction (NLDO) [78]. According to these previous studies, these tears were more alkaline, had a higher calcium concentration, contained inflammatory cytokines, and were unstable in the proportion of tear proteins compared with normal patients [78]. In 2001, there was a report that tear LLT after dacryocystorhinostomy [9].…”

Antimicrobial Chemokines

“…American College of Physicians, Copyright 2005. All rights reserved 2 Bulmer and Forwell (1956), Kaiser et al (1974) . 3 Chicharro et al (1994) . 4 Lew et al (2005) . 5 Cavaliere et al (1988), Cavaliere et al (1989) . 6 Moritz (2008) . 7 Wheeler et al (1960) . 8 Shiau (1987) . 9 Koo and Gupta (1982), Wack et al (1997) .…”

Meibomian Gland Dysfunction in Primary Acquired Nasolacrimal Duct Obstruction

“…13 Specifically, according to Lew et al, in the tears of PANDO patients, the concentrations of calcium and inflammatory cytokines were higher than those in the tears of normal eyes. 13 In this study, the primary aim was to demonstrate whether MGD can be a cause of persistent epiphora after DCR. In patients with MGD, decreased lipid secretion due to destruction or obstruction of Meibomian glands can lead to evaporative dry eye disease, and reflex hypersecretion of lacrimal glands can be a cause of epiphora.…”