Adjunctive use of mitomycin C on endoscopic lacrimal surgery

Zílelíoğlu, Güler; Uğurbaş, Suat Hayri; Anadolu, Yücel; Akıner, Metin; Aktürk, Tevfik

doi:10.1136/bjo.82.1.63

Cited by 115 publications

(18 citation statements)

References 19 publications

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“…The contribution of antifibrotic agents, such as mitomycin C, to the success rate of both external and endonasal DCR surgery has been previously reported [19,20]. In this study, all of the cases showed fibrosis over the surgical area due to previous surgeries; however, none of the cases had been treated with antifibrotic agents.…”

Section: Discussionmentioning

confidence: 47%

Unsuccessful Lacrimal Surgery: Causative Factors and Results of Surgical Management in a Tertiary Referral Center

Konuk¹,

Kurtulmusoglu²,

Knatova³

et al. 2010

Ophthalmologica

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Background: To evaluate possible causative factors of unsuccessful dacryocystorhinostomy (DCR) surgery, and present the surgical technique and results of revision external DCR in a tertiary referral center. Methods: During 2001–2007, 79 patients (59 female, 20 male, 83 revised DCR sites) underwent revision external DCR for the management of recurrent epiphora after unsuccessful DCR surgery. The possible reasons for unsuccessful DCR surgery were noted according to the preoperative nasal endoscopic and perioperative findings, and revision surgery was performed to address these. Results: The mean age was 43.1 ± 12.0 years, and the mean follow-up was 21.4 ± 12.4 months. At presentation, 58 patients had a history of 1 unsuccessful lacrimal surgery, 16 had 2 unsuccessful surgeries, and 5 had 3 unsuccessful surgeries. The most common preoperative endoscopic finding was nasal mucosal fibrosis and synechiae, and the most common causes of unsuccessful DCR surgery were inappropriate size and location of the bony ostium, fibrosis at rhinostomy site, and canalicular obstruction, respectively. Of the 83 revised DCR sites, 79 sites underwent external DCR with silicone intubation, and conjunctival DCR with Jones tube insertion was performed in 4 sites. Success was achieved in 78 sites (93.9%) with the first revision DCR surgery, and in 81 sites (97.6%) with the second revision. Conclusions: Revision DCR has standard concepts in common with primary DCR surgery; however, for a favorable surgical outcome, the revision surgery should address possible causative factors of failure.

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Section: Discussionmentioning

confidence: 47%

Unsuccessful Lacrimal Surgery: Causative Factors and Results of Surgical Management in a Tertiary Referral Center

Konuk¹,

Kurtulmusoglu²,

Knatova³

et al. 2010

Ophthalmologica

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“…Of these 19 articles, 8 were noncomparative case series [23]–[30] and not suitable for inclusion in the meta-analysis (Table 1). The left 11 comparative studies (including 9 RCTs and 2 non-RCTs) which met our inclusion criteria were included in the final meta-analysis [10]–[15], [31]–[35].…”

Section: Resultsmentioning

confidence: 99%

“…The dose of MMC used ranged between 0.2 and 0.5 mg/mL, which was placed on the ostium for 2 to 15 minutes. Silicone tubes were used in five studies [11], [14], [15], [31], [35]. Table 2 presents the characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of Mitomycin C in Endoscopic Dacryocystorhinostomy: A Systematic Review and Meta-Analysis

Cheng

Feng

et al. 2013

PLoS ONE

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BackgroundA number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the clinical results of EN-DCR with and without MMC.Methods and FindingsA comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant trials comparing EN-DCR with and without MMC. Eleven studies including 574 eyes were included in this meta-analysis. The success was defined as patency of the nasolacrimal canal and symptomatic improvement. There was significantly higher success rate in the MMC group in comparison with control group [RR = 1.12, 95% CI (1.04, 1.20), P = 0.004]. A sensitivity analysis after the non-randomized controlled trials were excluded from the meta-analysis demonstrated no differences compared with the overall results. Subgroup analyses showed that MMC group had a significantly higher success rate than control group in primary and revision EN-DCR, and EN-DCR without silicone intubation, but no difference in the subgroup of with silicone intubation. The size of the osteotomy site was bigger in the MMC group compared to the control group at 3 months [WMD = 7.65, 95% CI (0.33, 14.98), P = 0.041] and 6 months [WMD = 9.28, 95% CI (2.45, 16.11), P = 0.008] after surgery. However, there was statistically significant difference in the osteotomy surface area between the two groups at 12 months after surgery [WMD = 11.63, 95% CI (−1.04, 24.29), P = 0.072].ConclusionIntraoperative MMC application seems to be a safe adjuvant that could reduce the closure rate of the osteotomy and enhance the success rate after both primary and revision EN-DCR.Trial RegistrationClinicalTrials.gov NCT01772277

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“…Zilelioglu и соавт. [9] впервые применили мито-мицин-С в дакриологии после выполнения стандартной эндоскопической эндоназальной ДЦР (ЭДЦР). В область сформированной ДС авторы помещали хирургическую губку, обработанную раствором митомицина-С в концен-трации 0,5 мг/мл, на 2,5 мин таким образом, чтобы вся окружающая слизистая оболочка находилась в контакте с ней.…”

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Therapeutic methods of scar prevention at the site of endonasal dacryocystorhinostomy

Atkova

Root

2015

Vestn. oftal'mol.

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Adjunctive use of mitomycin C on endoscopic lacrimal surgery

Abstract: Adjunctive use of a wound healing inhibitor is considered to increase the success rate of endoscopic endonasal DCR. Its intraoperative use seems to be easy and safe. But the study of this limited series shows no benefit in using it.

Cited by 115 publications

References 19 publications

Unsuccessful Lacrimal Surgery: Causative Factors and Results of Surgical Management in a Tertiary Referral Center

Unsuccessful Lacrimal Surgery: Causative Factors and Results of Surgical Management in a Tertiary Referral Center

Efficacy of Mitomycin C in Endoscopic Dacryocystorhinostomy: A Systematic Review and Meta-Analysis

Therapeutic methods of scar prevention at the site of endonasal dacryocystorhinostomy

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