Biomechanical properties of lacrimal drainage pathways in dacryostenosis

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Abstract

BACKGROUND: In the literature, there is a deficit of data regarding clinical and morphological correlations in characterizing lacrimal drainage pathways. However, changes in the biomechanical properties of the lacrimal drainage pathways may influence the clinical picture of dacryostenosis, and may also have a predictive value in the context of prognosis of surgical procedures.

AIM: The aim of this study is to study of changes in the viscoplastic properties of the lacrimal sac wall in dacryostenosis

MATERIALS AND METHODS: The study included 38 patients with dacryostenosis. All patients underwent a biometric examination of lacrimal drainage pathways to determine the average area of their section. All observations were divided into cases with stenotic changes (at an average section area of the lacrimal drainage pathways less than 0.18 mm2 — 26 observations) and with ectatic changes (at an average section area of lacrimal drainage pathways equal to or more than 0.18 mm2 — 12 observations). The biomechanical properties of lacrimal sac wall samples obtained during dacryocystorinostomy were analyzed. The peak value of the viscosity of the lacrimal sac wall and the integral viscosity of the lacrimal sac wall (AUC) were determined.

RESULTS: In patients with stenotic changes, a correlation was determined between the duration of lacrimation and the average section area of lacrimal drainage pathways (r = –0.537, p = 0.018), in patients with ectatic changes, a correlation was determined between the average section area of lacrimal drainage pathways and the peak value of the viscosity of the lacrimal sac wall (r = 0.662, p = 0.019). No correlations of biometric parameters with the integral viscosity of the lacrimal sac wall (AUC) were found.

CONCLUSIONS: At stenotic changes in lacrimal drainage pathways, the average area of their section depends on the duration of lacrimation; this dependence is absent when a critical level of ectasia is reached. With an increase in the average cut area of lacrimal drainage pathways, the value of the peak viscosity of the lacrimal sac wall increases.

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About the authors

Eugenia L. Atkova

M.M. Krasnov Research Institute of Eye Diseases

Email: evg.atkova@mail.ru
ORCID iD: 0000-0001-9875-6217
SPIN-code: 1186-4060

MD, Dr. Sci. (Мedicine)

Russian Federation, 11A Rossolimo st., Moscow, 119021

Vasily D. Yartsev

M.M. Krasnov Research Institute of Eye Diseases

Email: v.yartsev@niigb.ru
ORCID iD: 0000-0003-2990-8111
SPIN-code: 4151-4946

MD

Russian Federation, 11A Rossolimo st., Moscow, 119021

Ivan A. Novikov

M.M. Krasnov Research Institute of Eye Diseases

Email: ivan.a.novikov@gmail.com
ORCID iD: 0000-0003-4898-4662
SPIN-code: 3560-1550

MD

Russian Federation, 11A Rossolimo st., Moscow, 119021

Maksim A. Ekaterinchev

M.M. Krasnov Research Institute of Eye Diseases

Author for correspondence.
Email: maximus-ek@mail.ru
ORCID iD: 0000-0001-8268-2540
SPIN-code: 9251-2884

MD

Russian Federation, 11A Rossolimo st., Moscow, 119021

Yulia V. Mazurova

M.M. Krasnov Research Institute of Eye Diseases

Email: julia.mazurova@bk.ru
ORCID iD: 0000-0003-2503-842X
SPIN-code: 2093-0888

MD, Cand. Sci. (Medicine)

Russian Federation, 11A Rossolimo st., Moscow, 119021

References

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  2. Ali MJ, Paulsen F. Etiopathogenesis of primary acquired nasolacrimal duct obstruction: what we know and what we need to know. Ophthalmic Plast Reconstr Surg. 2019;35(5):426–433. doi: 10.1097/IOP.0000000000001310
  3. Kashkouli MB, Sadeghipour A, Kaghazkanani R, et al. Pathogenesis of primary acquired nasolacrimal duct obstruction. Orbit. 2010;29(1):11–15. doi: 10.3109/01676830903207828
  4. Makselis A, Petroska D, Kadziauskiene A, et al. Acquired nasolacrimal duct obstruction: clinical and histological findings of 275 cases. BMC Ophthalmol. 2022;22(1):12. doi: 10.1186/s12886-021-02185-x
  5. Yartsev VD, Atkova EL, Ekaterinchev MA. Topographic and anatomical features of the nasolacrimal duct obstruction due to radioiodine treatment. Int Ophthalmol. 2023;43(9):3385–3390. doi: 10.1007/s10792-023-02746-7
  6. Fedorov AA, Atkova EL, Yartsev VD. Secondary acquired nasolacrimal duct obstruction as a specific complication of treatment with radioactive iodine (morphological study). Ophthalmic Plast Reconstr Surg. 2020;36(3):250–253. doi: 10.1097/IOP.0000000000001521
  7. Atkova EL, Yartsev VD, Krakhovetskiy NN. Disorders of lacrimal drainage: the way from theory to practice. Russian Annals of Ophthalmology. 2023;139(3–2):7180. doi: 10.17116/oftalma202313903271 EDN: QAQSBF
  8. Yang MK, Sa H-S, Kim N, et al. Bony nasolacrimal duct size and outcomes of nasolacrimal silicone intubation for incomplete primary acquired nasolacrimal duct obstruction. PLoS One. 2022;17(3):e0266040. doi: 10.1371/journal.pone.0266040

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. The biometric analysis of the vertical segment of lacrimal drainage pathways. Highlighted by red color is the X-ray volume corresponding to the contrast-enhanced part of the vertical segment of lacrimal drainage pathways

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3. Fig. 2. Diagram of the indenting device. 1, Actuator; 2, hydraulic system; 3, indenter ; 4, strain-gauge

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4. Fig. 3. Dynamic viscosity of the sample

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5. Fig. 4. Correlations between the studied parameters: a, duration of lacrimation and average area of section of lacrimal drainage pathways (excesses are excluded) in patients with stenotic changes; b, peak values of the dynamic viscosity and average area of the nasolacrimal duct in patients with ectatic changes

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