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Updated: Feb 18, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
[Mitomycin C after endoscopic endonasal dacryocystorhinostomy]
E L At'kova1, G V Ramenskaya2, A O Root1
1Research Institute of Eye Diseases, 11A, B Rossolimo St., Moscow, Russian Federation, 119021.
Abstract:
Mitomycin-C (MMC) is the most frequently used agent for prevention of excessive scarring at the osteotomy site after endoscopic endonasal dacryocystorhinostomy (EEDCR), which, however, being applied during the final stage of the surgery, shows questionable effectiveness.
Aim:
to evaluate the effectiveness of a new administration route of mitomycin C in EEDCR.
Material And Methods:
The study included 86 patients (95 cases) in the age range of 62.3±9 years with primary acquired nasolacrimal duct obstruction. All patients underwent P.J. Wormald modification of EEDCR and were further divided into 2 groups. In group 1, MMC was injected into the nasal cavity and lacrimal sac mucosa, while in group 2 it was applied locally according to the standard procedure. To measure tissue concentrations of MMC, mucosal biopsies were taken in patients of Group 1. Systemic absorption of MMC was studied through blood samples in both groups. Clinical efficacy was assessed in 14±5 months after surgery.
Results:
immediately after injection, the average tissue concentration of mitomicyn C in patients of Group 1, was 390±10 µg/g and 30 minutes later - 120±20 µg/g. No mitomycin C was found in Day 1 tissue samples and in any of the blood samples. Positive clinical results were reported in 97.9% of cases from Group 1 and in 87.2% of cases from Group 2.
Conclusion:
The method of injecting MMC during the final stage of EEDCR has proved clinically effective and safe and can be recommended for use in clinical practice.
Insights
A new injection method for Mitomycin-C (MMC) in endoscopic endonasal dacryocystorhinostomy (EEDCR) significantly improved surgical outcomes. This safe and effective technique offers a promising alternative for preventing excessive scarring after EEDCR procedures.
Area of Science:
- Ophthalmology
- Otolaryngology
- Surgical Innovation
Background:
- Mitomycin-C (MMC) is commonly used to prevent scarring after endoscopic endonasal dacryocystorhinostomy (EEDCR).
- The standard topical application of MMC during EEDCR shows questionable effectiveness due to its application timing.
Purpose of the Study:
- To evaluate the efficacy of a novel administration route for Mitomycin-C (MMC) in endoscopic endonasal dacryocystorhinostomy (EEDCR).
- To assess the safety and clinical effectiveness of intraoperative MMC injection into the nasal cavity and lacrimal sac mucosa.
Main Methods:
- Eighty-six patients (95 cases) with primary acquired nasolacrimal duct obstruction underwent P.J. Wormald modification of EEDCR.
- Patients were divided into two groups: Group 1 received intra-nasal and lacrimal sac mucosal MMC injection, while Group 2 received standard topical MMC application.
- Tissue and blood samples were analyzed for MMC concentration, and clinical outcomes were assessed at 14±5 months post-surgery.
Main Results:
- Immediate post-injection MMC tissue concentrations in Group 1 were 390±10 µg/g, decreasing to 120±20 µg/g after 30 minutes.
- No MMC was detected in Day 1 tissue samples or any blood samples, indicating minimal systemic absorption.
- Clinical success rates were significantly higher in Group 1 (97.9%) compared to Group 2 (87.2%).
Conclusions:
- Intraoperative injection of Mitomycin-C (MMC) into the nasal cavity and lacrimal sac mucosa is clinically effective for preventing scarring in EEDCR.
- This new administration route demonstrates a favorable safety profile with no detectable systemic absorption.
- The findings support the recommendation of this innovative MMC delivery method for routine clinical practice in EEDCR.
