Efficacy of probing the nasolacrimal duct with adjunctive Mitomycin-C for epiphora in adults.
OBJECTIVE
To investigate the efficacy and safety of adjunctive low-dose mitomycin-C during lacrimal probing for adults with blocked nasolacrimal ducts.


METHODS
Prospective, noncomparative, interventional case series.


METHODS
From January 1998 to December 2000, a total of 32 adult patients (36 eyes) seen with epiphora caused by primary nasolacrimal duct obstruction was treated and evaluated.


METHODS
Lacrimal probing with adjunctive mitomycin-C (0.2 mg/ml).


METHODS
Objective evaluation of patency with irrigation, as well as patients' subjective assessment of improvement.


RESULTS
For 32 of the treated eyes (89%), the nasolacrimal duct remained open 9 months after treatment. Repeat procedure was successful for two of the remaining four eyes with recurrent obstruction during follow-up, yielding an overall patency rate of 94%. Patient satisfaction was assessed after 9 months and indicated that the epiphora was at least mildly improved for 30 (83%) of the treated eyes. Watering was completely absent for nine eyes (25%), rated as moderately improved for 17 (47%), and mildly improved for 4 (11%). No complications were encountered over the 9-month follow-up period.


CONCLUSIONS
Our experience suggests good long-term results for probing with adjunctive, topical Mitomycin-C for cases of adult epiphora caused by obstruction of the nasolacrimal duct followed by repeat procedure if necessary. It can be recommended as a simple, effective, and minimally invasive technique, with no significant complications resulting from low-dose use in our study.
Tsai
Chieh-Chih
CC
Department of Ophthalmology, Veterans General Hospital-Taipei, No. 201 Sec. 2, Shih-Pai Road, Taipei, Taiwan, R.O.C. cctsai@vghtpe.gov.tw
Kau
Hui-Chuan
HC
Kao
Shu-Ching
SC
Hsu
Wen-Ming
WM
Liu
Jorn-Hon
JH
D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009301:Nasolacrimal Duct / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin