1 The main or orbital lacrimal gland is generally acknowledged to be the principal source for the aqueous component of tears and for many of the proteins that protect the surface from bacterial attack. TEAR SECRETION is required for protection of the ocular surface and for the maintenance of the optical properties of the cornea. However, the nature of neural control of the accessory glands is not yet clear. No histological changes were seen in corneal, conjunctival, or eyelid tissues 20 weeks after surgery.Ĭonclusions 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.Ĭlinical Relevance This study shows that total removal of the main lacrimal gland does not in itself lead to keratoconjunctivitis sicca. The main and accessory lacrimal glands appeared to secrete similar types of proteins. However, no gross abnormalities or fluorescein staining were seen in 5 of the 6 monkeys, and the conjunctival surfaces remained normal. 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. Methods Unilateral main lacrimal gland removal in 6 squirrel monkeys was followed by Schirmer testing, slitlamp 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. Objective To study the effects of lacrimal gland removal on basal and reflex tear production and on the ocular surface in the squirrel monkey. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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