Use of Mitomycin C in Repeat Dacryocystorhinostomy

Yeatts, R. Patrick; Neves, Robert

doi:10.1097/00002341-199901000-00005

Cited by 49 publications

(22 citation statements)

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“…36 The wound healing process of nasal ostium created by endoscopic DCR is dependent on reciprocal interactions between various cytokines and the different cell types lining the lacrimal sac and nasal mucosa. The tears from the two recurred eyes had significantly increased TGF-b2 and FGF-2 levels in comparison with eyes with good surgical results.…”

Section: Discussionmentioning

confidence: 99%

Changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction

Lee

Kim

2014

Eye

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Purpose We attempted to compare the cytokine composition of tears between primary acquired nasolacrimal duct (NLD) obstruction and normal controls. We investigated the changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy (DCR). Patients and methods Eighteen patients underwent endonasal DCR, with seven patients undergoing bilateral DCR, resulting in twenty-five DCRs in total. Eleven contralateral un-operated eyes were used as normal controls. Silicone stents were removed 3 months after surgery. Tear samples were collected from all eyes before surgery, and at 1 month, 2 months, 3 months, and 4 months after surgery. The level of interleukin (IL)-1b, IL-2, IL-6, IL-10, transforming growth factor (TGF)-b2, fibroblast growth factor (FGF)-2, and vascular endothelial growth factor (VEGF) in the tears was measured. Results The concentrations of IL-2, IL-6, IL-10, VEGF, and FGF-2 were significantly higher in eyes with NLD obstruction than controls before surgery (P ¼ 0.006, 0.018, 0.002, 0.048, and 0.039, respectively). Most inflammatory cytokines (IL-1b, IL-2, IL-6, VEGF, and FGF-2) were higher in the tears of the DCR group compared with the controls during the postoperative follow-up, but then rapidly decreased to the level of the controls after removal of the silicone stent. The recurred eyes showed a higher level of TGF-b2 and FGF-2 in tears compared with the eyes that showed good surgical results (Po0.005 and o0.005, respectively). ConclusionThe tear levels of inflammatory cytokines were higher in eyes with NLD obstruction than controls. The changes in cytokine level during the postoperative period showed the importance of cytokine analysis in understanding wound healing after DCR.

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Section: Discussionmentioning

confidence: 99%

Changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction

Lee

Kim

2014

Eye

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“…They stated that intraoperative MMC is effective in maintaining a larger osteotomy size. Yeatts and Neves [14] recommended that the adjunctive use of MMC might increase the success rate of repeat DCR.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of adjunctive use of mitomycin C in external dacryocystorhinostomy

et al. 2007

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The satisfaction and success rates of the MMC group were higher than those of the control group and no deleterious effect was noted with MMC application, however the differences did not reach statistical significance. Intraoperative MMC application seems to be a safe adjuvant that could help in increasing the success rates of EXT-DCR surgery in primary acquired nasolacrimal duct obstruction ,however further studies with larger series are needed to make definite statements.

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“…They concluded that mitomycin C soaking can result in a decrease in density and cellularity of mucosa, and hence, enhance the success of DCR surgery 16. Yeatts and Neves reported eight cases of repeat DCR using mitomycin C soaking with successful results 17. They recommended that the adjunctive use of mitomycin C may increase the success rate of repeat DCR.…”

Section: Discussionmentioning

confidence: 99%

Results of intraoperative mitomycin C application in dacryocystorhinostomy

Liao

2000

British Journal of Ophthalmology

136

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Aims-To evaluate the long term results of intraoperative mitomycin C application in dacryocystorhinostomy (DCR) surgery compared with results of the conventional procedure. Methods-In this prospective randomised controlled study, a total of 88 eyes diagnosed with acquired nasolacrimal duct obstruction were randomly divided into a conventional DCR group and a mitomycin C group in which mitomycin C was used during DCR surgery. The surgical procedures in both groups were exactly the same, except that in the patients in the mitomycin C group, a piece of neurosurgical cottonoid soaked with 0.2 mg/ml mitomycin C was applied to the osteotomy site for 30 minutes. The results of the DCR surgeries were evaluated by objective findings such as irrigation and the height of tear meniscus and subjective symptoms by asking patients the condition of tearing improvement. Results-Among the 44 eyes in the mitomycin C group, 95.5% of patients remained totally symptom free after 10 months of follow up; while in the conventional group, 70.5% of patients were reported to be symptom free and 18% of patients to have an improvement in their symptoms. There was a significant diVerence between these two groups. As far as objective findings were concerned, there were 41 eyes in the mitomycin C group classified as having a normal and one eye with moderate tear meniscus level, compared with 32 eyes and seven eyes, respectively, in the conventional group. There was also a significant diVerence between these two groups. The non-patency rate in the mitomycin C group is 4.5% compared with 11.4% in the conventional group. There were no complications such as abnormal nasal bleeding, mucosal necrosis, or infection except one patient with delayed wound healing. Conclusions-Intraoperative mitomycin C application is eVective in increasing the success rate of DCR surgery in standard nasolacrimal duct obstruction, and no significant complications resulted from its use. (Br J Ophthalmol 2000;84:903-906) Most ophthalmic surgeons accept dacryocystorhinostomy (DCR) as a highly successful procedure in managing epiphora due to nasolacrimal duct obstruction. From previous studies, it appears that the success rate for this procedure is about 90%.1-3 The two most frequent causes of DCR failure are obstruction of the common canaliculus and closure of the osteotomy site.4-6 Thus, if we can inhibit fibrous tissue growth and scarring by applying antiproliferative agents over the anastomosed flaps and osteostomy site, the failure rate may be decreased.Mitomycin C, an antiproliferative agent, has been widely used in pterygium excision and trabeculectomy with favourable results. 7 8 Our previous study also demonstrated that DCR with intraoperative mitomycin C application can maintain larger osteotomy size than that of the conventional procedure.9 In this paper, we evaluate the long term success rate of DCR surgery with intraoperative mitomycin C soaking. Subjects and methodsDuring 1995 to 1998, 88 patients with a diagnosis of primary acquired nasolacrimal duct...

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Use of Mitomycin C in Repeat Dacryocystorhinostomy

Cited by 49 publications

References 0 publications

Changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction

Changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction

Long-term results of adjunctive use of mitomycin C in external dacryocystorhinostomy

Results of intraoperative mitomycin C application in dacryocystorhinostomy

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