Results of Intraoperative Mitomycin C Application in Dacryocystorhinostomy

ABSTRACT

This study was undertaken to evaluate the long term results 0f intraoperative mitomyc in C appIication in dacryocystorh inostomy (DCR) surgery compared WIith results of the conventiona I procedure. In this prospect were randomly controlled study, a totaI 0f 44 eyes diagnosed with acqu ired nasolacrimal duct obstruction were randomly divided into a conventional DCR group and a mitomyein C group in which mitomycin C was used during DCR surgery. The surgical procedures in both groups were exactly the same. except that in the patients in the mitomycin C group, a piece of neurosurgical cottonoid soaked with 0.2 mg/ml mitomycin C was applied to the osteotom) site for 30 minutes. The results of the DCR surgeries were evaluated by objective findings such as irrigation and the height of tear meniscus and subjective symptoms like condition of tearing Among the 22 eyes in the I n C grou p. 95.45% of patients remained totally symptom free after 9 months 0f follow up; while in the conventional group. 72.72% o("patients were reported to be symptom free and 18% 01" patients to have all improvement ill their symptoms. There was a significant difference between these h\o groups. As far as objective findings were concerned. there were 21 eyes in the mitomycin C group classified as having normal and one eye with moderate tear meniscus level. compared with 16 eyes and 3 eyes. respectivel), in the conventional group. There was also a significant difference between these two groups. The non-patency rate in the mitomycin C group was 4.50/0 compared with II A% in the conventional group. There were no complications such as abnormal nasal bleeding. Thus lucosalnecrosis or infection except one patient with delayed wound healing. Thus intraoperative mitomycin C application was effective in increasing the success rate of DCR surgery in standard nasolarcimal duct obstruction and no significant complications resulted from its use.