Intraoperative use of mitomycin C during dacryocystorhinostomy in adult patients with primary nasolacrimal duct obstruction may improve functional and anatomical outcomes compared with controls. The use of the drug was associated with an increase in the size of anatomical openings, a decrease in the formation of granulation tissue, and a decrease in the need for surgical treatment of the wound.
Scientists from Harvard Medical School and the University of Michigan analyzed data from 24 clinical trials to evaluate the effectiveness of mitomycin C during dacryocystorhinostomy in adults with primary nasolacrimal duct obstruction. The study results were published in the journal Ophthalmology.
The analysis found that mitomycin C improved functional outcomes in three of nine studies. During endoscopic endonasal dacryocystorhinostomy, the drug improved functional outcomes in one of nine studies. During revision endoscopic endonasal dacryocystorhinostomy, mitomycin C significantly improved functional outcomes in one of three studies. However, in the case of transcanalicular laser dacryocystorhinostomy, the use of the drug did not lead to a statistically significant improvement in results.
Mitomycin C concentrations ranged from 0.05 to 1 mg/mL, with the most common concentration being 0.2 mg/mL in 12 studies. The duration of drug use ranged from 2 to 30 minutes.
Experts have confirmed that the use of mitomycin C can increase the size of the nasolacrimal duct opening six months after surgery, reduce the formation of granulation tissue and reduce the need for surgical debridement.
Adverse effects associated with the use of mitomycin C have been rare. Only one patient out of 750 showed delayed healing of the skin wound, which indicates an acceptable level of risk when using the drug.