Skip to main content
SpringerLink
Log in

Lacrimal sac dacryoliths (86 samples): chemical and mineralogic analyses

  • Oculoplastics and Orbit
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

Because dacryoliths occur at low frequency, few studies have focused on their composition. We aimed to present findings from morphological, chemical, and mineralogic analysis of 86 dacryoliths.

Methods

We studied 86 dacryoliths obtained during 832 dacryocystorhinostomies (DCR) performed for postsaccal obstruction. We examined the samples with atomic infrared spectrometry (80 samples), amino acid analysis (17 samples), scanning electron microscopy, and an electron microprobe with an energy dispersive detector (seven samples).

Results

Dacryoliths were found in 86/832 DCRs (10.3 %), mostly in patients with primary acquired nasolacrimal duct obstruction. All the dacryoliths were soft, composed of organic material, including proteins and mucoproteins, with approximately 20 % amino acid content. There were no “hard” dacryoliths composed of calcium phosphate. The stones were composed of lobes and lobules built on an amorphous core material with small cavities, probably as a result of various chemical processes that produced a gaseous product. The most frequent elements found in inorganic inclusions were silicon, magnesium, sulfur, potassium, calcium, sodium, and chlorine. Also, some particles had high contents of bismuth, titanium, iron, and organic fibers. The fibers found in the core of dacryoliths suggested a potential origin from cotton swabs used in cosmetics.

Conclusion

Dacryoliths are composed almost exclusively of organic material, including proteins and mucoproteins, with approximately 20 % amino acid content.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Paulsen F (2007) Pathophysiological aspects of PANDO, dacryolithiasis, dry eye, and punctum plugs. In: Weber RK, Keerl R, Schaefer SD, Della Rocca RC (eds) Atlas of lacrimal surgery. Springer, Berlin, pp 15–27

    Chapter  Google Scholar 

  2. Repp DJ, Burkat CN, Lucarelli MJ (2009) Lacrimal excretory system concretions: canalicular and lacrimal sac. Ophthalmology 116:2230–2235

    Article  PubMed  Google Scholar 

  3. Hurwitz JJ (1996) Diseases of the Sac and Duct. In: Hurwitz JJ (ed) The lacrimal system, 1st edn. Lippincott Raven, Philadelphia, pp 117–138

    Google Scholar 

  4. Iliadelis ED, Karabatakis VE, Sofoniou MK (2006) Dacryoliths in a series of dacryocystorhinostomies: histologic and chemical analysis. Eur J Ophthalmol 16(5):657–662

    CAS  PubMed  Google Scholar 

  5. Orhan M, Onerci M, Dayanir V, Orhan D, Irkec T, Irkec M (1996) Lacrimal sac dacryolith: a study with atomic absorption spectrophotometry and scanning electron microscopy. Eur J Ophthalmol 6(4):478–480

    CAS  PubMed  Google Scholar 

  6. Iliadelis E, Karabatakis V, Sofoniou M (1999) Dacryoliths in chronic dacryocystitis and their composition (spectrophotometric analysis). Eur J Ophthalmol 9(4):266–268

    CAS  PubMed  Google Scholar 

  7. Herzig S, Hurwitz JJ (1979) Lacrimal sac calculi. Can J Ophthalmol 14(1):17–20

    CAS  PubMed  Google Scholar 

  8. Paulsen FP, Schaudig U, Fabian A, Ehrich D, Sel S (2006) TFF peptides and mucins are major components of dacryoliths. Graefes Arch Clin Exp Ophthalmol 244(9):1160–1170

    Article  CAS  PubMed  Google Scholar 

  9. Paulsen FP (2008) Anatomie und Physiologie der ableitenden Tränenwege. Ophthalmologe 105:339–345

    Article  CAS  PubMed  Google Scholar 

  10. Viers ER (1976) Lacrimal disorders. CV Mosby, St. Louis, pp 150–180

    Google Scholar 

  11. Berlin AJ, Rath T, Rich L (1980) Lacrimal system dacryoliths. Ophthalmic Surg 11(7):435–6

    CAS  PubMed  Google Scholar 

  12. Halborg J, Prause JU, Toft PB, Skjødt K, Tommerup NR, Nielsen OF, Heegaard S (2009) Stones in the lacrimal gland: a rare condition. Acta Ophthalmol 87:672–675

    Article  PubMed  Google Scholar 

  13. Komínek P, Červenka S, Doskářová S, Heiderová D, Slabík D, Hušek P, Buryška J (2002) Cesk Slov Oftalmol 58(3):205–211

    PubMed  Google Scholar 

  14. Cassotis NJ, Schiffman P (2006) Calcification associated with the nasolacrimal system of a horse: case report and mineralogic composition. Vet Ophthalmol 9(3):187–190

    Article  PubMed  Google Scholar 

  15. McCormick SA, Linberg JV (1988) Pathology of nasolacrimal duct obstruction. clinicopathologic correlates of lacrimal excretory system disease. In: Linberg JV (ed) Lacrimal surgery. Churchill Livingstone, New York, pp 169-202

    Google Scholar 

  16. Baratz KH, Bartley GB, Campbell RJ, Garrity JA (1991) An eyelash nidus for dacryoliths of the lacrimal excretory and secretory systems. Am J Ophthalmol 111:624–627

    CAS  PubMed  Google Scholar 

  17. Lew H, Lee SY, Yun YS (2004) Measurement of pH, electrolytes and electrophoretic studies of tear proteins in tear of patients with dacryoliths: a novel concept for dacryoliths. Ophthalmologica 18(2):130–135

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Mrs Hana Tomášková for her assistance in statistical analytical corrections that contributed to the final version of this paper.

Financial support

None.

Proprietary interest statement

There are no financial interests related to the manuscript, including stock or ownership of a business entity connected to a product described in the paper, paid consulting for the company or competing companies, or patent rights to a drug or piece of equipment.

Clinical trials reference number

NCT01826734

Author information

Authors and Affiliations

  1. Department of Otolaryngology, University Hospital Ostrava, 17. listopadu Street 1790, 708 52, Ostrava Poruba, Czech Republic

    Pavel Komínek, Stanislav Červenka, Karol Zeleník & Petr Matoušek

  2. Public Health Institute of Ostrava, Centre of Hygiene Laboratories, Ostrava, Czech Republic

    Šárka Doškářová & Karel Lach

  3. Institut of Laboratory Diagnostics, University Hospital Ostrava, Ostrava, Czech Republic

    Zdeněk Švagera

  4. Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic

    Zdeněk Švagera, Karol Zeleník & Petr Matoušek

  5. Department of Ophthalmology, Otrokovice, Czech Republic

    Stanislav Červenka

Authors
  1. Pavel Komínek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Šárka Doškářová
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zdeněk Švagera
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karel Lach
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stanislav Červenka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Karol Zeleník
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Petr Matoušek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pavel Komínek.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Komínek, P., Doškářová, Š., Švagera, Z. et al. Lacrimal sac dacryoliths (86 samples): chemical and mineralogic analyses. Graefes Arch Clin Exp Ophthalmol 252, 523–529 (2014). https://doi.org/10.1007/s00417-013-2501-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-013-2501-6

Keywords

Search

Navigation