Is the main lacrimal gland indispensable? Contributions of the corneal and conjunctival epithelia

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• 作者：William Stevenson ; MD^a ; Sangeethabalasri Pugazhendhi^b ; Mingwu Wang ; MD ; PhD^a ; ^{mwang@eyes.arizona.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：tear secretion ; ocular surface system ; main lacrimal gland ; accessory lacrimal gland ; corneal epithelium ; conjunctival epithelium ; rebamipide ; diquafosol
• 刊名：Survey of Ophthalmology
• 出版年：2016
• 出版时间：September-October 2016
• 年：2016
• 卷：61
• 期：5
• 页码：616-627
• 全文大小：841 K

文摘

The ocular surface system is responsible for ensuring that the precorneal tear film is sufficient in both quality and quantity to preserve optimal vision. Tear secretion is a complex, multifactorial process, and dysfunction of any component of the ocular surface system can result in tear film instability and hyperosmolarity with resultant dry eye disease. The tear film is primarily composed of lipids, aqueous, and mucins, with aqueous accounting for most of its thickness. The aqueous is produced by the main lacrimal gland, accessory lacrimal glands, and corneal and conjunctival epithelia. Although the main lacrimal gland has long been considered an indispensable source of the aqueous component of tears, there is evidence that adequate tear secretion can exist in the absence of the main lacrimal gland. We review and discuss the basics of tear secretion, the tear secretory capacity of the ocular surface, and emerging treatments for dry eye disease.