title: Mitomycin-C in dacryocystorhinostomy: From experimentation to implementation and the road ahead: A review.
abstract: Dacryocystorhinostomy (DCR) is the procedure of choice in patients with epiphora due to primary acquired nasolacrimal duct obstruction. The evolution of surgical tools, fiber-optic endoscopes, effective anesthesia techniques, and the adjunct use of antimetabolites intraoperatively; namely mitomycin-C (MMC) have significantly contributed to the advancement of DCR surgery. MMC is a systemic chemotherapeutic agent derived from Streptomyces caespitosus that inhibits the synthesis of DNA, cellular RNA, and protein by inhibiting the synthesis of collagen by fibroblasts. Even the cellular changes in the human nasal mucosal fibroblasts induced by MMC at an ultrastructural level have been documented. There, however, seems to be a lack of consensus regarding MMC: The dosage, the route of delivery/application, the time of exposure and subsequently what role each of these variables plays in the final outcome of the surgery. In this review, an attempt is made to objectively examine all the evidence regarding the role of MMC in DCR. MMC appears to improve the success rate of DCR.
authors.affiliation: Department of Ophthalmic Plastic Surgery and Ocular Oncology, Advanced Eye Hospital and Institute, Navi Mumbai; Department of Ophthalmic Plastic Surgery and Ocular Oncology, Aditya Jyot Eye Hospital, Mumbai; Department of Ophthalmology, Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India.
authors.forename: Akshay Gopinathan
authors.initials: AG
authors.lastname: Nair
authors.forename: Mohammad Javed
authors.initials: MJ
authors.lastname: Ali
mesh_terms: D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000628:therapy*; D016685:Mitomycin / Q000008:administration & dosage*; D019384:Nucleic Acid Synthesis Inhibitors / Q000008:administration & dosage; D011183:Postoperative Complications / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin