Intraoperative mitomycin C in dacryocystorhinostomy

Purpose: To assess the efficacy of intraoperative mitomycin C (MMC) in exte rnal dacryocystorhinostomy (EXT-DCR). Methods: Forty-six cases (50 lacrimal drainage systems [LDS]) with nasolacr imal duct obstruction were randomized into three groups. In the control gro up, a standard EXT-DCR procedure was performed. In the two MMC groups, a pi ece of cotton soaked with 0.2 mg/ml MMC (group 1) or 0.5 mg/ml MMC (group 2 ) was applied to the nasal mucosa and the mucosa of the lacrimal sac in the osteotomy site for 5 minutes. Results: The dacryocystorhinostomy in all patients was patent by irrigation 2 to 3 weeks postoperatively. After a mean follow-up interval of 35.2 +/- 5.3 months, the dacryocystorhinostomy was patent in 15 (83%) of 18 LDS in t he control group, 16 (100%) of 16 LDS in group 1, and 15 (94%) of 16 LDS in group 2. The mean ostium sizes were 22.2 +/- 5.0 mm(2) in group 1, 20.6 +/ - 4.5 mm(2) in group 2, and 13.2 +/- 2.7 mm(2) in group 3 at the final foll ow-up visit; the difference between the patients treated with MMC and the c ontrol group was statistically significant. There was no statistically sign ificant difference between the two MMC groups, however. No surgical com pli cations occurred. Conclusions: Intraoperative MMC in DCR is a safe and effective adjuvant tha t helps achieve favorable long-term success rates.