topical mitomycin c in dacriocystorhinostomy: its effect on failure rate of procedure - a randomized clinical trial

Introduction. Epiphoria is one of the most common symptom among patients in ophtalmologic clinics. The most important cause of it, is tear drainage obstrution through the nasolacrimal duct. Dacryocystorhinostomy (DCR) is the only critical treatment. The failure is important complication of DCR and in spite of varios methods, failure rate has remained 10 percent. Ingrowgh of fibrous tissue in osteotomy site and flaps has been known as cause of surgical failue. In this study we investigated the efficacy of mitomycin C as antiproliferative agent on DCR failure rate. Methods. In this clinical trial study, 110 patients with primary acquired nasolacrimal duct obstruction have been chosen between who that refer to the Farabi clinic, and were assigned randomly to either mitomycin or control group. Both group were operated with standard method and one surgen. In control group a cotton aid band and in interventional group a cottonoid band soaked with 0.2 mg/cc mitomycin C was applied to the osteotomy site. After 30 minutes was removed transnasaly. Groups have been examined at 1, 3 and 6 months intervals after surgery. Results. All patients in mitomycin group remained symptom free in all examination, and there was five pateints in control group who had recurrent epiphora. In the control group, 3 patients in 1 st month, 1 patient in 3rd months and 1 patient in 6th month were failed. In 3 patients of mitomycin group, severe post operative bleeding was seen. Discussion. The difference between these groups is (P < 0.01). Intraoperative mitomycin C may possibly improve success rates of DCR procedure with no serious complication.