Mitomycin C in Non-Endoscopic Endonasal Dacryocystorhinostomy: No Enhanced Outcome

Strategic Insights -

Researchers from L.V. Prasad Eye Institute have conducted a large, double-blind randomized clinical trial to evaluate the effectiveness of mitomycin C (MMC) application in non-endoscopic endonasal dacryocystorhinostomy (NEED) for adults with primary acquired nasolacrimal duct obstruction (PANDO). The study, which included 442 patients, found no statistically significant difference in structural patency and sustained patency between the MMC and control groups. The study's findings suggest that routine use of MMC in NEED for adults with PANDO should be reconsidered.

Key Takeaways:

  • The study involved 442 patients with PANDO, of which 314 were female, and found no statistically significant difference in structural patency and sustained patency between the MMC and control groups.
  • The mean follow-up time for the MMC and control groups was 35.7±26.8 vs. 36.5±28.0 months, respectively.
  • Complete success in the MMC and control groups was 94.6% vs. 95% at one year and 93% vs. 94% at 5 years, respectively.
  • The most common complications in both groups were granuloma at the ostium (4.5%) and prolapse of the tube (4.0%).
  • The study concluded that MMC application at the ostium did not enhance the outcome in NEED for adults with PANDO, and its routine use should be reconsidered in this setting.

Statistics:

  • 442 patients were recruited for the study, with 314 (71%) being female.
  • The mean age of the patients was 43.9±13.5 years, with no statistically significant difference between the MMC and control groups (p = 0.64).
  • The mean follow-up time for the MMC and control groups was 35.7±26.8 vs. 36.5±28.0 months, respectively.
  • The primary outcome measure was structural patency by lacrimal irrigation at 6 months, with no statistically significant difference between the MMC and control groups (p = 0.74).
  • Complete success in the MMC and control groups was 94.6% vs. 95% at one year and 93% vs. 94% at 5 years, respectively.

Sources:

  • American Journal of Ophthalmology, "Mitomycin C in Non-Endoscopic Endonasal Dacryocystorhinostomy: A Randomized Clinical Trial involving 442 cases."
  • NewsRx, "Researchers from L.V. Prasad Eye Institute Report New Studies and Findings in the Area of Ostomy (Mitomycin C in Non-Endoscopic Endonasal Dacryocystorhinostomy: A Randomized Clinical Trial involving 442 cases)."