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Peer-reviewed veterinary case report

Chronic Electrical Stimulation for Tear Secretion: Lacrimal vs. anterior ethmoid nerve.

Journal:
The ocular surface
Year:
2019
Authors:
Kossler, Andrea L et al.
Affiliation:
Department of Ophthalmology · United States
Species:
rabbit

Abstract

PURPOSE: To evaluate and compare the effect of lacrimal nerve stimulation (LNS) and anterior ethmoid nerve stimulation (AENS) on aqueous tear secretion, and tissue condition following chronic implantation. METHODS: A neurostimulator was implanted in rabbits adjacent to the (1) lacrimal nerve, and (2) anterior ethmoid nerve. Tear volume was measured with Schirmer test strips after stimulation (2.3-2.8&#x202f;mA pulses at 30&#x202f;Hz for 3-5&#x202f;min), and scores were compared to sham stimulation. Lacrimal gland and nasal septal tissue were evaluated histologically after chronic stimulation (2 weeks-7 months). RESULTS: LNS increases tear volume by 32% above sham (p&#x202f;<&#x202f;0.05, n&#x202f;=&#x202f;5), compared with 133% for AENS (p&#x202f;&#x2264;&#x202f;0.01, n&#x202f;=&#x202f;6). AENS also significantly increases tear secretion in the fellow, non-stimulated eye (p&#x202f;&#x2264;&#x202f;0.01, n&#x202f;=&#x202f;6), as expected from the tearing reflex pathway. Histologically, chronic LNS is well tolerated by surrounding tissues while chronic AENS results in nasal mucosal fibrosis and implant extrusion within 3 weeks. CONCLUSIONS: AENS is significantly more effective than LNS at enhancing aqueous tear secretion, including the fellow eye. The lacrimal implant is well tolerated, while the nasal implant requires further design optimization to improve tolerability.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/31476515/