Intraoperative Mitomycin C Use During Filtration Surgery and Lacrimal Drainage System Obstruction

Abstract

To evaluate the effect of intraoperative mitomycin C (MMC) application during filtration surgery on lacrimal drainage system. Prospective, nonrandomized, comparative, observational case series. All glaucomatous patients with previous filtration surgery with or without intraoperative MMC application were included. An ophthalmology resident took a detailed history and performed a general eye examination. Patients with ocular and periocular diseases and previous procedures that could affect the lacrimal drainage system were excluded. Diagnostic probing and irrigation of lacrimal drainage system were performed by a masked oculoplastic surgeon. There were 76 eyes from 60 patients with intraoperative MMC (MMC group) and 35 eyes from 24 patients without intraoperative MMC (non-MMC group) application. Two groups were matched for all the variables except for significantly longer duration of being on topical anti-glaucoma medications in the non-MMC group. Lacrimal drainage system obstruction was found in 18.4% of MMC and 22.8% of non-MMC group (P = .61). Upper lacrimal drainage system obstruction was insignificantly more in the MMC group. Duration of MMC application (one to five minutes) did not have significant impact on lacrimal drainage system obstruction. Patients with lacrimal drainage system obstruction were significantly more symptomatic (wet eye). Intraoperative MMC application during filtration surgery did not have a statistically significant impact on the rate of lacrimal drainage system obstruction.