Long-term results of adjunctive use of mitomycin C in external dacryocystorhinostomy.

OBJECTIVE: To assess the long-term results of intraoperative mitomycin C (MMC) in external dacryocystorhinostomy (EXT-DCR).

METHODS: In this prospective randomized controlled study, 35 patients (40 eyes) with primary acquired nasolacrimal duct obstruction were assigned randomly into two groups. In the control group, a standard EXT-DCR procedure was performed. In the MMC group 0.2 mg/ml MMC was applied to the osteotomy site for 30 min. The results of EXT-DCR in both groups were evaluated by both asking patients about the tearing condition and examining the patency of irrigation at one-year follow up.

RESULTS: Eighteen (90%) of the 20 eyes in the MMC group remained totally symptom-free and one eye (5%) improved; while 12 (60%) of 20 eyes in the control group were reported to be symptom-free and five (25%) of the eyes to have an improvement in the tearing symptoms (P = 0.087). The success rate in the MMC group was 95% compared with 85% in the control group (P = 0.605). No surgical complications occurred.

CONCLUSIONS: The satisfaction and success rates of the MMC group were higher than those of the control group and no deleterious effect was noted with MMC application, however the differences did not reach statistical significance. Intraoperative MMC application seems to be a safe adjuvant that could help in increasing the success rates of EXT-DCR surgery in primary acquired nasolacrimal duct obstruction ,however further studies with larger series are needed to make definite statements.