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Silicone intubation with MMC shows efficacy as alternative to dacryocystorhinostomy
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Silicone intubation may be an effective alternative procedure to dacryocystorhinostomy in patients with simple epiphora, according to a prospective study. The additional use of mitomycin-C intraoperatively may also significantly improve surgical success, particularly among patients with a longer duration of symptoms, the authors noted.
Syed Ziaeddin Tabatabaie, MD, and colleagues evaluated the efficacy of applying MMC intraoperatively during silicone intubation in patients with nasolacrimal duct obstruction. The procedure was performed as a substitute for dacryocystorhinostomy.
The study included 88 patients randomly assigned to surgery involving either 0.2 mg/mL of MMC applied for 2 minutes before silicone intubation or a placebo application.
At 8 months mean follow-up, 25 of 43 eyes in the MMC-treated group and 21 of 44 eyes in the placebo group had a successful outcome, with no significant difference between groups, according to the study.
"In patients with simple epiphora and less than 6 months of duration, [silicone intubation] alone was effective in 83% of patients; however, in the same group, MMC application during [silicone intubation] did not show beneficial effect over [silicone intubation] alone," the authors reported.
"But in patients with simple epiphora of 6-months duration or longer, the application of MMC during [silicone intubation] resulted in better efficacy compared with [silicone intubation] alone," they said.
Patients who had chronic dacryocystitis had a 23% success rate compared with a success rate of 63.7% among patients who had only epiphora (63.7%), they said.
The study is published in the November/December issue of Ophthalmic Plastic and Reconstructive Surgery.