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Year : 2018  |  Volume : 2  |  Issue : 2  |  Page : 80-84

Closed intubation with mitomycin C application for patients older than two years having nasolacrimal duct obstruction

Department of Ophthalmology, Al Azhar University, Cairo, Egypt

Correspondence Address:
Hossam Eldin A Ziada
Department of Ophthalmology, Al Azhar University, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjamf.sjamf_20_18

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Purpose The aim was to explore the safety and efficacy of silicon intubation with mitomycin C (MMC) in increasing the success rate of closed intubation in patients older than 2 years. Patients and methods This prospective study included thirty eyes of 24 consecutive patients with tearing and discharge owing to primary and acquired partial nasolacrimal duct obstruction. Their ages ranged from 2.5 to 40 years, and the male/female ratio was 10/14. Probing of nasolacrimal duct with silicone intubation (SI) (which is soaked in MMC 0.2 mg/ml for 2 min) was done in all cases, but it was abandoned if the resistance or obstruction was too difficult to overcome or if excessive bleeding or a hard blind bony pouch at the end of the nasolacrimal duct was detected. This occurred in five patients (5/35). In these patients, dacryocystorhinostomy was performed, and they were excluded from our study. Results The procedure was successful in 24 eyes and unsuccessful in six eyes. The success is defined as prevention of recurrence of duct obstruction after removal of silicon tubes 3±1.7 months from intubation. The mean age of the patients with unsuccessful outcomes was 22.4±3.4 years, whereas those with successful outcomes was 8.0±2.8 years, and the difference was statistically significant (P=0.006). Sex (P>0.05) was not statistically different. No serious intraoperative and/or postoperative complications were observed. Conclusion The results of our prospective study showed that SI with MMC in patients with simple epiphora has a success rate of 80%. This success rate was achieved by other studies using SI alone but in younger age group. In our study, an older patient group was included with almost the same success rate. We can conclude that MMC application during SI does not appear to have additional benefit over SI alone in young children with simple epiphora, as shown in other studies by different authors, whereas the application of MMC during SI would result in better efficacy compared with SI alone in older age patients.

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