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John Albinsson, MSc, PhD

John Albinsson

Research engineer

John Albinsson, MSc, PhD

Novel Evidence Concerning Lacrimal Sac Movement Using Ultra-High-Frequency Ultrasound Examinations of Lacrimal Drainage Systems

Author

  • Elin Bohman
  • Johanna Berggren
  • Josefine Bunke
  • John Albinsson
  • Karl Engelsberg
  • Ulf Dahlstrand
  • Jenny Hult
  • Hideyuki Hasegawa
  • Magnus Cinthio
  • Rafi Sheikh

Summary, in English

PURPOSE: Current hypothesis regarding the mechanism of active tear drainage is based on studies performed ex vivo or under nonphysiological conditions. Novel ultra-high-frequency ultrasound has the advantage of generating images with superior resolution, enabling measurements of low flow in small vessels, and the tracking of tissue motion in real time. The purpose of this study was to investigate the lacrimal drainage system and active drainage using this modality.

METHODS: The upper lacrimal drainage system was investigated with 40-70 MHz ultrasound in 22 eyes in 13 patients. Irrigation confirmed a lacrimal obstruction in 10 eyes. Motion tracking was used to map movement of the lateral lacrimal sac wall and to measure flow when possible.

RESULTS: The anatomy of the upper lacrimal drainage system was mapped in vivo, including the proximal canaliculi, which have not previously been imaged. The lacrimal sac lumen is slit shaped in its resting state but is distended when irrigated or if a nasolacrimal duct obstruction is present. Thus, the healthy lacrimal sac is not a cavity, and the medial retinaculum does not act against a stretched structure. Motion tracking visualized the "lacrimal pump," showing that the direction of motion of the lateral lacrimal sac wall is mainly in the sagittal plane during blinking.

CONCLUSIONS: Ultra-high-frequency ultrasound allows detailed physiological monitoring of the upper lacrimal drainage system in vivo. Our findings suggest that current theories of active tear drainage need to be reappraised.

Department/s

  • Ophthalmology Imaging Research Group
  • Ophthalmology, Lund
  • Clinical Sciences, Helsingborg
  • Department of Biomedical Engineering
  • Division for Biomedical Engineering

Publishing year

2021

Language

English

Pages

334-340

Publication/Series

Ophthalmic Plastic and Reconstructive Surgery

Volume

37

Issue

4

Document type

Journal article

Publisher

Lippincott Williams & Wilkins

Topic

  • Ophthalmology

Status

Published

Research group

  • Ophthalmology Imaging Research Group

ISBN/ISSN/Other

  • ISSN: 1537-2677