Intraoperative mitomycin C in dacryocystorhinostomy.
OBJECTIVE
To assess the efficacy of intraoperative mitomycin C (MMC) in external dacryocystorhinostomy (EXT-DCR).


METHODS
Forty-six cases (50 lacrimal drainage systems [LDS]) with nasolacrimal duct obstruction were randomized into three groups. In the control group, a standard EXT-DCR procedure was performed. In the two MMC groups, a piece of cotton soaked with 0.2 mg/ml MMC (group 1) or 0.5 mg/ml MMC (group 2) was applied to the nasal mucosa and the mucosa of the lacrimal sac in the osteotomy site for 5 minutes.


RESULTS
The dacryocystorhinostomy in all patients was patent by irrigation 2 to 3 weeks postoperatively. After a mean follow-up interval of 35.2 +/- 5.3 months, the dacryocystorhinostomy was patent in 15 (83%) of 18 LDS in the control group, 16 (100%) of 16 LDS in group 1, and 15 (94%) of 16 LDS in group 2. The mean ostium sizes were 22.2 +/- 5.0 mm2 in group 1, 20.6 +/- 4.5 mm2 in group 2, and 13.2 +/- 2.7 mm2 in group 3 at the final follow-up visit; the difference between the patients treated with MMC and the control group was statistically significant. There was no statistically significant difference between the two MMC groups, however. No surgical complications occurred.


CONCLUSIONS
Intraoperative MMC in DCR is a safe and effective adjuvant that helps achieve favorable long-term success rates.
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Department of Ophthalmology, First Affiliated Hospital, Wenzhou Medical College, China.
Fang
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CT
D000293:Adolescent; D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000517:prevention & control; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D009297:Nasal Mucosa / Q000187:drug effects*; D009301:Nasolacrimal Duct / Q000187:drug effects*; D011446:Prospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
D016685:Mitomycin