ABSTRACT
PURPOSE: To determine the safety and efficacy of the multiple postoperative applications of mitomycin-C (MMC) after endocanalicular laser dacryocystorhinostomy. METHODS: Prospective interventional case series of 125 endocanalicular laser dacryocystorhinostomies using the diode laser. Mitomycin-C was placed intra-operatively in all cases. Application of MMC was also done postoperatively at 1 week, 2 weeks, and 3 weeks. The main outcome measure for success was resolution or improvement of epiphora, the patency of the osteum and the presence or absence of complications from the MMC application. Patients were followed up for at least 12 months. RESULTS: A total of 125 consecutive endocanalicular laser dacryocystorhinostomies on 114 patients (102 women, 12 men, mean age 60 years) were done from January 2002 to January 2005. The success rate at 12 months postoperatively was 92.8%. All failures were due to cicatricial closure of the osteum. No significant intra-operative and postoperative nasal complications from the MMC were recorded. CONCLUSION: Multiple postoperative applications of MMC appears to be a safe and effective adjunctive modality after endocanalicular laser dacryocystorhinostomy in primary acquired nasolacrimal duct obstruction.
Subject(s)
Alkylating Agents/administration & dosage , Dacryocystorhinostomy , Laser Therapy , Mitomycin/administration & dosage , Nasolacrimal Duct/drug effects , Adult , Aged , Alkylating Agents/adverse effects , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Lacrimal Duct Obstruction/physiopathology , Lasers, Semiconductor/therapeutic use , Male , Middle Aged , Mitomycin/adverse effects , Postoperative Period , Prospective Studies , Treatment OutcomeABSTRACT
PURPOSE: To determine the safety and efficacy of the diode laser with intraoperative mitomycin C in endocanalicular laser dacryocystorhinostomy (ECL-DCR). METHODS: In a prospective case series of 40 ECL-DCRs using the diode laser, mitomycin C was placed intraoperatively in all cases. The main outcome measure was resolution or improvement of epiphora and no major laser damage intranasally. Patients were followed for at least 18 months. RESULTS: Forty consecutive ECL-DCRs on 30 patients (23 females, 7 males, mean age 62 years) were performed from April 2000 to December 2001. The success rate at 12 months postoperatively was 87.5%. All failures were due to a constricted nasal osteotomy. No significant intraoperative or postoperative complications were recorded. CONCLUSIONS: Diode laser ECL-DCR with mitomycin C appears to be a safe and effective treatment modality for primary acquired nasolacrimal duct obstruction.