title: Clinical outcomes of dacryocystorhinostomy with or without intraoperative use of mitomycin C: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To examine the possible benefit of intraoperative use of mitomycin C (MMC) application in dacryocystorhinostomy (DCR) and to assess its potential risk.
  
  
  METHODS
  Systematic review and meta-analysis of randomized-controlled trials (RCTs). A comprehensive literature search was performed according to a protocol set in advance. The participants included 811 patients of which 820 eyes were sampled for 14 RCTs. Only pertinent RCTs were identified and included in this meta-analysis. The primary efficacy measure was "patency of irrigation" at follow-up end point. The subjective outcome of "symptom relief" was also extracted as a secondary efficacy measure. For each study, relative risk was extracted. Heterogeneity, publication bias, subgroup, and meta-regression analyses were performed.
  
  
  RESULTS
  RevMan version 5.0 software was used for statistical analysis. In the primary efficacy measure, the use of MMC can significantly increase the rate of "patency of irrigation" [risk ratio (RR), 1.10; 95% confidence interval (CI), 1.04-1.17; P=0.0006]; the outcome of "symptom relief" was also affected by the use of MMC (RR, 1.15; 95% CI, 1.05-1.26; P=0.003). Sensitivity analysis suggested that the result was comparatively reliable.
  
  
  CONCLUSIONS
  Intraoperative use of MMC can bring about a positive effect to the outcomes of "patency of irrigation" and "symptom relief," which increases the success rate of DCR surgery.
authors: Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China .
authors: Zhuyun
authors: Z
authors: Qian
authors: Yidan
authors: Y
authors: Zhang
authors: Xianqun
authors: X
authors: Fan
mesh_terms: D002921:Cicatrix / Q000517:prevention & control; D003607:Dacryocystitis / Q000473:pathology / Q000517:prevention & control / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000379:methods*; D004334:Drug Administration Schedule; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000473:pathology / Q000517:prevention & control; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence
chemical_list: D016685:Mitomycin