Dacryocystorhinostomy without intubation with intraoperative mitomycin-C.
OBJECTIVE
To evaluate the success rate and complications of intraoperative Mitomycin-C in dacryocystorhinostomy (DCR) surgery.


METHODS
Quasi-experimental study.


METHODS
Isra postgraduate institute of Ophthalmology, Al-Ibrahim Eye Hospital, Malir, Karachi, from January 2003 to December 2004.


METHODS
This study included total 90 eyes of 90 patients fulfilling the inclusion criteria. The surgical procedure of external DCR done with intraoperative Mitomycin-C with a neurosurgical cottonoid soaked with 0.2 mg/ml. Mitomycin C was applied to the anastomosed flaps and osteotomy site for 10 minutes, without Silicon tube intubation. Surgery was done under local as well as general anesthesia. Patients were followed for 6 months.


RESULTS
Out of 90 patients included in this study, only 2 patients complained of persistent epiphora after 6 months follow-up and were labeled as failed DCR. Remaining 88 had either no tearing or significant improvement of tearing after 6 months follow up and patent lacrimal system by syringing without pressure. Success rate in this procedure was 97.77% (p-value < 0.001). This study showed very high rate of success. Only complication noted was excessive nasal bleeding which was easily controlled.


CONCLUSIONS
Intraoperative Mitomycin-C application in external DCR is safe, effective, cheap adjunct that helps to achieve good results of DCR surgery.
Rahman
Azizur
A
Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Malir City, Karachi. drgeja@hotmail.com
Channa
Shahnawaz
S
Niazi
Jawaid Hassan
JH
Memon
Muhammad Saleh
MS
D000293:Adolescent; D000328:Adult; D002648:Child; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D007766:Lacrimal Apparatus Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*
D016685:Mitomycin