To investigate the interventional factors and therapeutic efficacy of probing with mitomycin-c as treatment of complete , primary , acquired nasolacrimal duct obstruction in adults.

Glayool Safshekanesfahani

Purpose: To investigate the interventional factors and therapeutic efficacy of probing with mitomycin-c as treatment of complete , primary , acquired nasolacrimal duct obstruction in adults.

Methods : 140 adult patients with NLD obstarction were evaluated in a prospective , comparative , interventional study and randomized into two groups. In the control group (n=69) probing and sac syringing was done alone. In the study group (n=71) probing was done , followed with irrigation by mitomycin-c. Follow up examinations were conducted 2 weeks after the procedure , and then 1,3,6 and 9 months to evaluate objective patency rate and subjective improvment. Age , sex , location and side of obstruction in association with the success rate of operation, also were assessed in this study.

Results : After 9 months , objective success rate in study group was 67.6% and in control group was 23.9% (p<0.01). Furthermore , in study group 21 eyes (31.3%) remained patent completely in comparison with 7.4% in control group (p<0.01). In subjective assessment , the overall improvement in the study group was 76.1 % with complete relief of symptoms in 25.4 % of patients. There was no significant statistical association between success rate of operation and sex , age , location , side of obstruction in the study group (p>0.05). However the success rate of operation in males was higher than females in the study group.

Conclusion : The results of this study demonstrate that MMC , used as an adjunct for NLD probing can improve both subjective and objective outcomes without imposing significant additional risks. Also interventional factors had no effect statistically on the success rate of operation.