Efficacy of postoperative mitomycin-C eye drops on the clinical outcome in endoscopic dacryocystorhinostomy

Purpose: To evaluate the effect of postoperative topical mitomycin-C (MMC) eye drops in endoscopic (dacryocystorhinostomy) DCR and compare them with intraoperative MMC soaking. Design: Retrospective, nonrandomized, interventional case series. Methods: One hundred and sixty cases of endoscopic DCR with a single surgeon for primary nasolacrimal duct obstruction (NLDO) were included. Cases were divided into three groups. Group 1 was treated with intraoperative application of 0.02 % MMC for 5 min. Group 2 was treated with 0.02 % MMC eye drops for 5 days after surgery, without intraoperative application of MMC. Group 3 was the control group of cases without the use of MMC. Each group was evaluated for surgical success, presence of complications including granuloma, synechiae, and tube-induced inflammation, and the adverse effect of the MMC at least 6 months after the surgery. Results: The success rate showed no significant difference among the three groups (P =.122, chi-square analysis). In the analysis between the two groups, although the success rate of Group 2 appeared not to be statistically different compared with that of Group 1 (P =.419, chi-square analysis), Group 2 had a statistically higher success rate for surgery than Group 3 (P =.041, chi-square analysis). The presence of granuloma was significantly lower in Group 1 than in the other two groups (P =.022, chi-square analysis). Synechiae and silicone tube-induced inflammation were not significantly different (P =.308, P =.881, chi-square analysis). There were no adverse effects associated with intraoperative or postoperative MMC application. Conclusion: Use of postoperative topical 0.02 % MMC is a safe and effective adjunctive modality to increase the success rate of endoscopic DCR.