Silicone nasolacrimal intubation with mitomycin-C: a prospective, randomized,
double-masked study.
Author(s): Liu D(1), Bosley TM.
Affiliation(s): Author information:
(1)Department of Ophthalmology, University of Missouri, 1 Hospital Drive, Room EC
139, Columbia, MO 65212, USA. LiuD@health.missouri.edu
Publication date & source: 2003, Ophthalmology. , 110(2):306-10
OBJECTIVE: To determine if mitomycin-C (MMC) application during silicone
intubation (SI) can effectively substitute for dacryocystorhinostomy (DCR) or
Jones tube insertion.
DESIGN: A prospective, randomized, double-masked study.
PARTICIPANTS: Twenty-four patients (7 males, 17 females; aged 2-69 years) with 27
eyes (three bilateral cases) with an obstructed lacrimal system who were
candidates for DCR or Jones tube.
METHODS: All study patients underwent SI with application in a randomized,
double-masked fashion of MMC or placebo, with the former receiving 0.2 mg/ml MMC
for 2 minutes before SI.
MAIN OUTCOME MEASURES: Clinical assessment of tearing and discharge; Schirmer I
and II tests at 1, 3, 6, and 12 months; and the need for eventual DCR or Jones
tube insertion.
RESULTS: Follow-up ranged from 13 to 23 months (mean, 18 months; median, 17
months). Seven of the 12 eyes in the MMC group and 8 of the 15 eyes in the
placebo group had a successful outcome and remained symptom free. The difference
was not statistically significant (P = 0.79). Dacryocystorhinostomy or Jones tube
was performed in five eyes in the MMC group and in seven eyes in the placebo
group 3 to 18 months later; all had successful outcome and no complications.
Untoward effects of MMC application included a slit canaliculus and a transient
conjunctival injection. A successful outcome using this combined technique does
not appear to correlate with age, gender, laterality, and intraoperative bleeding
observed at the punctum or for the duration of symptoms.
CONCLUSIONS: Mitomycin-C application during SI did not benefit outcome.
Complications from such application were mild and infrequent.
|