The effect of mitomycin-C on 3 snip punctoplasty
Betül Dertsiz Kozan1, Bahadır Utlu2
1Gazi Yasargil Training and Research Hospital, Ophthalmology, Diyarbakır, Turkey. dr.dertsiz@hotmail.com.
Purpose:
To investigate the effects of Mitomycin-C (MMC) use and duration of application on surgical outcomes in patients who underwent 3 snip punctoplasty for epiphora.
Material And Methods:
Demographic characteristics, follow-up period, nasolacrimal passage patency, degree of punctum stenosis (graded between 0 and 5), presence of epiphora and accompanying diseases of the cases who applied with epiphora complaint between June 2015 and May 2024 were evaluated retrospectively. 3 snip punctoplasty was applied to all cases.The cases were divided into 3 groups. Group 1: 3 snip without MMC, group 2: 3 snip with 0.3% MMC for 1 min, group 3: 3 snip with 0.3% MMC for 2 min.
Results:
In this study, 180 eyes of a total of 90 cases were examined. 50 (55.5%) of the cases were female and 40 (44.5%) were male. The average age of the cases was 42.2 ± 3.8 (35-68).The average follow-up period was 6.2 ± 1.5 (6-8) months. In 2 of the cases (2.2%), the postoperative nasolacrimal lavage was closed at the punctum level. Preoperative punctal stenosis grade was 2 in 60 cases (66.6%) and 1 in 30 cases (33.4%). There were no postoperative epiphora complaints in 24 (80%) patients in group 1, 27 (90%) patients in group 2, and 28 (93.3%) patients in group 3. The difference between groups 1 and 2 was statistically significant (p < 0.05).The difference between groups 2 and 3 was not statistically significant (p > 0.05). Postoperative corneal epithelial defect development was observed in 1 of the cases.
Conclusions:
3 snip surgery is a successful method in the treatment of punctal stenosis, and the use of MMC may increase success. Increasing the duration of MMC application did not improve surgical success.
Insights
Mitomycin-C (MMC) use in 3 snip punctoplasty for epiphora improved surgical outcomes compared to no MMC. However, extending MMC application duration did not further enhance success rates in treating punctal stenosis.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Tear Drainage Disorders
Background:
- Epiphora, or excessive tearing, is often caused by punctal stenosis.
- 3 snip punctoplasty is a surgical technique to address punctal stenosis.
- Mitomycin-C (MMC) is an antimetabolite agent sometimes used adjunctively in ophthalmic surgery.
Purpose of the Study:
- To evaluate the impact of Mitomycin-C (MMC) application and its duration on the surgical success of 3 snip punctoplasty for epiphora.
- To compare outcomes between 3 snip punctoplasty with and without MMC, and with varying MMC application times.
Main Methods:
- Retrospective analysis of 90 patients (180 eyes) with epiphora due to punctal stenosis undergoing 3 snip punctoplasty.
- Patients were divided into three groups: no MMC, 0.3% MMC for 1 minute, and 0.3% MMC for 2 minutes.
- Surgical outcomes assessed included nasolacrimal passage patency and absence of epiphora post-surgery.
Main Results:
- No significant difference in postoperative nasolacrimal passage closure was observed.
- Success rates (no epiphora) were 80% without MMC, 90% with 1-minute MMC, and 93.3% with 2-minute MMC.
- A statistically significant improvement in success was noted between the no-MMC group and the 1-minute MMC group (p<0.05), but not between the 1-minute and 2-minute MMC groups (p>0.05).
Conclusions:
- 3 snip punctoplasty is an effective surgical treatment for punctal stenosis.
- The use of Mitomycin-C (MMC) appears to enhance the success rate of 3 snip punctoplasty for epiphora.
- Increasing the duration of MMC application beyond 1 minute does not yield additional significant benefits in surgical outcomes.
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