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  • Intraoperative Use of Mitomycin C in DCRs May Improve Outcomes

    Oculoplastics/Orbit

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    Review of: Use of mitomycin C in dacryocystorhinostomy: A report by the American Academy of Ophthalmology

    Freitag S, Aakalu V, Foster J, et al. Ophthalmology, November 2023

    Adjuvant mitomycin C (MMC) can be used during dacryocystorhinostomies (DCRs) performed on patients with nasolacrimal duct obstruction (NLDO). An Ophthalmic Technology Assessment published by the Academy explored the literature to assess adjuvant MMC's effect on patient outcomes.

    Study Design

    Studies were reviewed if they examined outcomes of DCRs in adults with primary acquired NLDO, included at least 6 months of follow-up, had at least 10 patients receiving adjuvant MMC, and were controlled studies. Twenty-four articles published before November 2022 were included, with a total of 750 patients undergoing DCR with MMC and 692 patients undergoing DCR alone (control group).

    Outcomes

    Greater success in outcome measures were shown with adjuvant MMC than without MMC in 3 of the 9 studies focusing on primary external DCRs and 1 of the 9 studies focusing on endoscopic DCRs. The remaining studies did not find significant differences between the MMC and control populations.

    Limitations

    Limitations included the relatively small numbers of patients in the prospective randomized studies, the wide variety of MMC concentrations and application times, and the relatively short 6-month follow-up time.

    Clinical Significance

    Intraoperative use of MMC in DCR may improve outcomes in some settings, but the lack of consensus on indication, concentration, and application of the medication limits the ability to make more definitive conclusions.

    Financial Disclosures: Dr. Anne Barmettler discloses no financial relationships.