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Anatomy and Histology of the Lacrimal Fluid Drainage System

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Anatomy and Histology of the Lacrimal Fluid Drainage System Okajimas Folia Anat. Jpn., 77(5): 155-160, December . 2000 Anatomy and Histology of the Lacrimal Fluid Drainage System By Rieko KOMINAMI, Satoru YASUTAKA, Yutaka TANIGUCHI and Harumichi SHINOHARA Department of Anatomy II, Kanazawa Medical University , Uchinada, Ishikawa 920-0265, Japan -Received for Publication, August 1, 2000- Key Words: Lacrimal fluid, Canaliculus, Common canaliculus, Lacrimal sac Summary: Five human specimens of the lacrimal canaliculus and sac were examined by light and scanning electron microsopy. The superior and inferior lacrimal canaliculi are lined with stratified squamous epithelium that is non- keratinized and non-mucin-producing. The common canaliculus is also lined with stratified squamous epithelium, but its lumen is much narrower than the lumen of the superior and inferior canaliculi. The common canaliculus opens into an ample space called the vestibule, where the epithelium changes to high pseudostratified columnar and then low pseudostratified columnar. The vestibule continues to the infundibulum of the lacrimal sac. The infundibulum is formed by several epithelial folds that radiate from the vestibular opening to the lacrimal sac. The vestibule and infundibulum are consistent transitional structures from the common canaliculus to the lacrimal sac. The connective tissue of the lamina propria from the common canaliculus to the lacrimal sac has two histological characteristics: numerous free cell aggregates (= lymphoid structure) and numerous venules and capillaries (= cavernous structure). Lacrimal fluid enters the punctum, passes Materials and Methods through the lacrimal canaliculus and sac, and finally drains into the nasal cavity through the nasolacri- Five human specimens of the lacrimal canaliculi mal duct. This duct system has been studied in and sac were obtained from two males and three terms of gross anatomy (Jones, 1961) and histology females, 68 to 92 years of age. One of the speci- (Fernandez-Valencia and Pellico, 1990; Paulsen et mens was embedded in paraffin, serially sectioned al., 1998), and it has also been studied in terms of in the sagittal planes, and stained with Meyer's tear drainage function (Doane, 1981; Hurwitz, hematoxylin and eosin. The remaining four speci- 1996) and immunologic self-defense (Paulsen et al., mens were dissected grossly or under a dissecting 1998). Earlier publications, however, are inade- microscope, and samples of the lacrimal canaliculus quate for understanding the morphology of the and sac were collected for semithin sections and lacrimal drainage system. For example , it is known scanning electron microscopy (SEM). The speci- that the canaliculus is lined by stratified squamous mens for semithin sections were fixed in 2.5% glu- epthelium and the lacrimal sac by pseudostratified taraldehyde in 0.1 M phosphate buffer solution epithelium (Ross and Romrell, 1985), but where (PBS) at pH 7.4 for an hour, dehydrated in a grade and how the former changes into the latter is series of ethanol, embedded in epoxy resin, and unknown. sliced 0.5 gm thick. The sections were then stained In the present study, we dissected the human with toluidine blue. The specimens for SEM were adult lacrimal canaliculus, lacrimal sac, and part of fixed in 2.5% glutaraldehyde in 0.1 M phosphate- the nasolacrimal duct. We also prepared histo- buffered saline (PBS) at pH 7.4 for an hour, post- logical sections and specimens for scanning electron fixed in 1% osmium tetroxide in PBS, dehydrated microscopy and discovered the presence of junc- in ethanol, critical-point-dried, gold-coated, and tional structures between the common canaliculus viewed with a scanning electron microscope (JSM- and lacrimal sac. 840, JEOL). 156 R. Kominamiet al. Results was varied in diameter from 100 to 250 micro- meters, possibly due to the planes of sectioning. The distance from the base of the inferior lac- The superior and inferior canaliculi did not join as rimal papilla to the lacrimal sac ranged from 12 to equal partners, instead the superior canaliculus 16 mm in these adult specimens. The superior lac- emptied into the inferior canaliculus like a small rimal punctum was situated approximately 3 mm branch emptying into the main stream. Conse- medial to the inferior lacrimal punctum. The lac- quently, the common canaliculus was more of a rimal canaliculus is divided into two portions: ver- continuation of the inferior canaliculus. The com- tical and horizontal. The vertical portion was about mon canaliculus was usually lined with stratified 2 mm in length and contained a few longitudinal squamous epithelium, but occasionally with pseu- folds (Fig. 1). Horner's muscle surrounded the ver- dostratified columnar epithelium (Fig. 5). Its lumen tical portion. Although the orientation of the indi- was less than 100 p,m in diameter, and narrower vidual muscle fibers were unclear, some muscle than the canalicular lumen. The common canal- fibers circled around the vertical portion, while iculus continued to the vestibule, whose lumen was others coursed parallel to it (Figs. 1 and 2). The several times the diameter of the common canal- muscle also surrounded the entire circumference of icular lumen. It was initially lined with high pseudo- the horizontal portion near the vertical portion. stratified columnar epithelium but converted to low Horner's muscle covered only the anterior surface pseudostratified columnar epithelium (Figs. 4A and in the horizontal portion near the common canal- 4B). The vestibule continued to the infundibulum iculus. The common canaliculus was approximately of the lacrimal sac. The lining of the lacrimal sac is 3 mm long when measured from the lacrimal sac in low pseudostratified columnar epithelium (Fig. 6), its thick connective tissue sheath. The lacrimal sac and the cells were approximately 30 gm in height. formed a small flat cistern medio-lateral diameter The basement membrane was thick for most part. of about 1 mm and a large antero-posterior diame- There were numerous mucin-producing cells in ter of about 2.5 mm. When the lacrimal sac was the lacrimal sac epithelium, and they often formed viewed from inside, the lateral wall was seen to clusters of secretory cells. Brown-pigment cells, contain a star-shaped slit approximately 2 mm from probably melanocytes, were also numerous in the the cranial end of the sac, and several epithelial lacrimal sac epithelium (Fig. 4A, arrowheads) and folds radiated from the center of the star. The slit subepithelial connective tissue. corresponds to the infundibulum of the lacrimal sac There were two distinctive features in the sub- (see the next paragraph). epithelial connective tissue from the common The canaliculus near the lacrimal punctum was canaliculus to the lacrimal sac: the presence of free lined with non-keratinized and non-mucin-produc- cell aggregates and numerous venules and capil- ing stratified squamous epithelium. It was clearly laries (Figs. 4A and 5). The cell aggregates were discriminated from the anteriorly-situated kerati- predominantly composed of lymphocytes, but mast nized epithelium of the palpebral epidermis (Figs. cells and plasma cells were common. Several capil- 3A and 3B) and from the posteriorly-situated laries 10-20 gm in diameter were usually present in mucin-producing epithelium of the conjunctiva the aggregates, and the area had appearance of (Figs. 3A and 3C). The canalicular epithelium was lymphoid tissue. Capillaries were not entirely ab- 75-150 gm in thickness and consisted of a few layers sent in the superior and inferior canaliculi, but were of squamous cells, several layers of polyhedral cells, far less in number than in the common canaliculus and a layer of basal cells. The canalicular lumen and lacrimal sac. Numerous small veins and capil- Explanation of Figures Plate I Fig. 1. Scanning electron microscopy view of the vertical portion of the inferior canaliculus. The lumen (L) is surrounded by the stratified squamous epithelium (SE). Cut-ends of circular muscle bundles are visible (arrows) between the longitudinal muscle bundles (M) and connective tissue (CT) of the lamina propria. Fig. 2. Semithin section stained with toluidine blue. Fig. 3. Paraffin section through the inferior lacrimal punctum. The epithelium of the canaliculus (C) is nonkeratinized and non- mucin-producing. Note the clear transition from the keratinized palpebral epidermis (arrowheads) and from the mucin- producing epithelium of the conjunctiva (arrows). Squares B and C correspond to insets. The arrows in the insets indicate the borders of the epithelia. PA; Palpebral aperture. Lacrimal Canaliculus and sac 157 Plate I 158 R. Kominamiet al. lanes in the common canaliculus and lacrimal sac might cause collapse of the common canaliculus at formed a cavernous structure. Some of the capil- the kink. Thus, reflux from the lacrimal sac toward lanes were adjacent to the basement membrane. the common canaliculus is blocked as though there The common canaliculus was consistently accom- were a valve at the junction. According to Hurwitz panied by a vein the diameter of which was nearly (1996), there is a sphincter muscle around the 1 mm. opening of the common canaliculus into the lac- rimal sac, and the sphincter prevents reflux. We did not find any valvular folds or a sphincter muscle at Discussion the common canaliculus-sac juction. However, we did find that the common canaliculus and lacrimal The results are schematically illustrated in sac were not connected directly but via transitional Figure 7. The non-keratinized and non-mucin-
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