Efficacy of Probing with Mitomycin-C in Adults with Primary Acquired Nasolacrimal Duct Obstruction

Abstract

To evaluate the efficacy and safety of adjunctive mitomycin-c (MMC) during probing in adults with primary nasolacrimal duct (NLD) obstruction. This is a prospective, comparative, randomized interventional study. A total of 40 adult patients with unilateral epiphora caused by primary NLD obstruction were treated and evaluated. Lacrimal probing and irrigation with adjunctive MMC (1 mL of 0.2 mg/mL, once) in cases and only probing in controls were done. At the end of 3 months, subjective improvement in epiphora and patency on syringing were evaluated. Complete subjective improvement in epiphora was found in 15% of cases as opposed to 0% in controls, at 3 months of follow-up. Moderate improvement was seen in 25% of cases as opposed to 5% of controls. Mild improvement was seen in 25% of cases as opposed to 35% in controls. The overall subjective improvement was seen in 65% of cases as opposed to 40% in controls. On syringing, NLD was patent in 30% of cases as opposed to 10% in controls at 3 months of follow-up, which was not significant. Use of intraoperative MMC improves the success of probing to some extent. Being a minimally invasive procedure, it can be tried in patients who refuse or are not systemically fit for undergoing dacryocystorhinostomy.