Azizur Rahman, Shahnawaz Channa, Jawaid Hassan Niazi, Muhammad Saleh Memon.
Dacryocystorhinostomy without intubation with intraoperative Mitomycin-C.
J Coll Physicians Surg Pak Jan ;16(7):476-8.

Objective: To evaluate the success rate and complications of intraoperative Mitomycin-C in dacryocystorhinostomy (DCR) surgery. Study Design:Quasi-experimental study. Place and Duration of Study: Isra postgraduate institute of Ophthalmology, Al-Ibrahim Eye Hospital, Malir, Karachi, from January 2003 to December 2004. Patients and Methods: This study included total 90 eyes of 90 patients fulfilling the inclusion criteria.The surgical procedure of external DCR done with intraoperative Mitomycin-C with a neurosurgical cottonoid soaked with 0.2mg/ml. Mitomycin C was applied to the anastomosed flaps and osteotomy site for 10 minutes, without Silicon tube intubation. Surgery was done under local as well as general anesthesia. Patients were followed for 6 months. Results: Out of 90 patients included in this study, only 2 patients complained of persistent epiphora after 6 months follow-up and were labeled as failed DCR. Remaining 88 had either no tearing or significant improvement of tearing after 6 months follow up and patent lacrimal system by syringing without pressure. Success rate in this procedure was 97.77% (p-value< 0.001). This study showed very high rate of success. Only complication noted was excessive nasal bleeding which was easily controlled. Conclusion: Intraoperative Mitomycin-C application in external DCR is safe, effective, cheap adjunct that helps to achieve good results of DCR surgery.

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