Efficacy of mitomycin C irrigation after removal of an occluded nasolacrimal stent.
OBJECTIVE
Mitomycin C (MMC) acts as a potent fibroblastic inhibitor, and topical application of MMC is effective in preventing scar formation. The purpose of this study was to evaluate the safety and efficacy of MMC irrigation after removal of an occluded nasolacrimal stent from the lacrimal system.


METHODS
A total of 57 lacrimal systems after removal of an occluded stent were assigned to one of two groups: 23 lacrimal systems were irrigated with MMC after stent removal (MMC group), and 34 lacrimal systems were not irrigated with MMC after stent removal (non-MMC group). In the MMC group, the lacrimal systems were irrigated with 0.2 mg/mL MMC through the inferior lacrimal punctum for 3 minutes in three different sessions: immediately, 1 week, and 1 month after stent removal. The mean and cumulative patency rates after stent removal were calculated using the Kaplan-Meier method and were compared between the two groups using the log-rank test.


RESULTS
Stent removal and MMC irrigation were technically successful in all lacrimal systems. There were no side effects or complications associated with MMC use. The mean patency rate after stent removal was higher in the MMC group than that of the non-MMC group: 10.5 months (95% CI: 7.04, 13.91) versus 4.5 months (95% CI: 2.40, 6.63), respectively. There was a statistically significant difference in the cumulative patency rates after stent removal between the two groups (P = .005, log-rank test).


CONCLUSIONS
Mitomycin C irrigation is safe and effective in increasing patency rate of lacrimal systems after removal of an occluded nasolacrimal stent.
Kim
Kyung Rae
KR
Department of Radiology and Research, Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea.
Song
Ho-Young
HY
Shin
Ji Hoon
JH
Kim
Jin Hyoung
JH
Choi
Eugene K
EK
Lee
Yong Jae
YJ
D000328:Adult; D000368:Aged; D003608:Dacryocystorhinostomy; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007765:Lacrimal Apparatus / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000601:surgery; D007767:Lacrimal Duct Obstruction / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D011474:Prosthesis Design; D011859:Radiography; D012189:Retrospective Studies; D055502:Secondary Prevention; D015607:Stents; D007507:Therapeutic Irrigation; D013997:Time Factors; D016896:Treatment Outcome
D016685:Mitomycin