Efficacy of Intraoperative Mitomycin C Eye Drops during and after Dacryocystorhinostomy for Canalicular Obstruction

Abstract

Purpose: This study investigated the efficacy of intraoperative and postoperative mitomycin C eye drops in patients with canalicular obstructions. Methods: In total, 46 eyes of 46 patients diagnosed with canalicular obstruction at our hospital between June 2012 and June 2016 were analyzed. Canalicular trephination was done and, after applying 0.02% mitomycin C for 3 minutes on the exposed lacrimal sac during endoscopic dacryocystorhinostomy, the area was washed with 20 mL of saline solution, and a silicon tube was inserted. On postoperative day 1, an antibiotic eye drop was applied; beginning on postoperative day 2, 0.02% mitomycin C eye drops were applied, and 0.5% steroid eye drops were applied. Pre- and postoperative anterior segment optical coherence tomography was used to measure the nasal, central, and lateral tear meniscus heights. The extent of functional improvement was assessed by measuring the degree of tear according to Munk's score, and anatomical improvement was assessed using a syringing test. Results: The nasal tear meniscus height decreased from 571.64 +/- 260.51 mu m to 267.16 +/- 59.25 mu m (p = 0.043); central tear meniscus height from 580.16 +/- 186.24 mu m to 271.14 +/- 45.10 mu m (p = 0.018); and lateral tear meniscus height from 480.52 +/- 260.23 mu m to 220.16 +/- 63.79 mu m (p = 0.029). The functional success rate was 93.5% (43/46), and the anatomical success rate was 95.7% (44/46). Conclusions: Intraoperative and postoperative mitomycin C and steroid eye drops may be an effective treatment for canalicular obstruction patients and should help increase surgical success rates.