Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial.
The current study aimed to determine the efficacy of probing with adjunctive mitomycin C (MMC) as a treatment for nasolacrimal duct obstruction (NLDO) in adults and to study the association of probing success with demographic and obstruction characteristics. This was a prospective, randomized, double-blind, placebo-controlled trial including 140 patients (each with a unilateral NLDO) scheduled for nasolacrimal probing who were randomly assigned to receive MMC (0.2 mg/ml, 70 patients; group A) or placebo (normal saline, 70 patients; group B). Irrigation was carried out with 0.5 cc of MMC (0.2 mg/mL) in the duct with a nasal pack for 10 minutes in group A. Patients' postprobing epiphora was evaluated at 2 weeks and 1, 3, 6, and 9 months postoperatively. Probing was judged to be a success if there was no or mild watering for at least 9 months after the procedure. There were no significant differences between the two study groups in demographic characteristics or duration of the operation (p=0.062). The overall success rate of probing with MMC was 47/70 (67.1%), which was significantly higher than the success rate of the procedure with placebo (p=0.0027). When the sex of the patients was controlled for by logistic regression, a significant association between the failure rate of probing and increasing age was found in cases and controls (p=0.004 vs. p=0.006, respectively). No significant side effects of probing with MMC were noted after 9 months of follow-up. Administering MMC in a dosage of 0.2 mg/mL during nasolacrimal probing significantly increased the success rate of probing. The failure rate of probing increased with age. A low dose of MMC is cheap, safe, and easily accessible; thus, it is recommended during nasolacrimal probing, especially in patients who refuse dacryocystorhinostomy surgery.
Department of Ophthalmology, Jahrom University of Medical Sciences, Jahrom, Iran.
Nader
N
Dehghani
Department of Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.
Mohamad Reza
MR
Fouladivanda
Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
Mohamed Amin
MA
Ghobadifar
Department of Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.
Gelayol
G
Safshekan-Esfahani
Department of Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Armin
A
Akbarzadeh
Adult; Lacrimal duct obstruction; Mitomycin