Topical application of mitomycin-C in endoscopic dacryocystorhinostomy

Endoscopic dacryocystorhinostomy (DCR) is a well-established alternative to external DCR for treatment of obstruction of the lacrimal pathway and has a success rate of up to 95% in primary cases. Despite the benefits of using an endoscopic approach, including enhanced intranasal access to the lacrim al drainage system, there still exists a significant failure rate, particul arly in revision procedures. As these failures are mainly due to obstructiv e postoperative adhesions, intraoperative adjuncts that prevent or minimize scarring should enhance the success rate. Endoscopic DCR was performed wit h intraoperative topical application of mitomycin-C, an antimetabolite ofte n used in ophthalmologic procedures to reduce scarring and formation of adh esions following surgery. The procedure tvas successful in 7 of 8 instances , with a follow-up of 3 to 27 months. In one procedure, obstruction recurre d 10 weeks after surgery. We feel that the results of this small series are encouraging and that further studies are warranted to determine the effect iveness of mitomycin-C as an adjunct to endoscopic DCR.