Dacryocystorhinostomy without intubation with intraoperative mitomycin-C.

J Coll Physicians Surg Pak

Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Malir City, Karachi.

Published: July 2006

Objective: To evaluate the success rate and complications of intraoperative Mitomycin-C in dacryocystorhinostomy (DCR) surgery.

Study Design: Quasi-experimental study.

Place And Duration Of Study: Isra postgraduate institute of Ophthalmology, Al-Ibrahim Eye Hospital, Malir, Karachi, from January 2003 to December 2004.

Patients And Methods: This study included total 90 eyes of 90 patients fulfilling the inclusion criteria. The surgical procedure of external DCR done with intraoperative Mitomycin-C with a neurosurgical cottonoid soaked with 0.2 mg/ml. Mitomycin C was applied to the anastomosed flaps and osteotomy site for 10 minutes, without Silicon tube intubation. Surgery was done under local as well as general anesthesia. Patients were followed for 6 months.

Results: Out of 90 patients included in this study, only 2 patients complained of persistent epiphora after 6 months follow-up and were labeled as failed DCR. Remaining 88 had either no tearing or significant improvement of tearing after 6 months follow up and patent lacrimal system by syringing without pressure. Success rate in this procedure was 97.77% (p-value < 0.001). This study showed very high rate of success. Only complication noted was excessive nasal bleeding which was easily controlled.

Conclusion: Intraoperative Mitomycin-C application in external DCR is safe, effective, cheap adjunct that helps to achieve good results of DCR surgery.

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