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Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial

The current study aimed to determine the efficacy of probing with adjunctive mitomycin C (MMC) as a treatment for nasolacrimal duct obstruction (NLDO) in adults and to study the association of probing success with demographic and obstruction characteristics. This was a prospective, randomized, doubl...

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Autores principales: Dehghani, Nader, Fouladivanda, Mohamad Reza, Ghobadifar, Mohamed Amin, Safshekan-Esfahani, Gelayol, Akbarzadeh, Armin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Chonnam National University Medical School 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406990/
https://www.ncbi.nlm.nih.gov/pubmed/25914876
http://dx.doi.org/10.4068/cmj.2015.51.1.19
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author Dehghani, Nader
Fouladivanda, Mohamad Reza
Ghobadifar, Mohamed Amin
Safshekan-Esfahani, Gelayol
Akbarzadeh, Armin
author_facet Dehghani, Nader
Fouladivanda, Mohamad Reza
Ghobadifar, Mohamed Amin
Safshekan-Esfahani, Gelayol
Akbarzadeh, Armin
author_sort Dehghani, Nader
collection PubMed
description The current study aimed to determine the efficacy of probing with adjunctive mitomycin C (MMC) as a treatment for nasolacrimal duct obstruction (NLDO) in adults and to study the association of probing success with demographic and obstruction characteristics. This was a prospective, randomized, double-blind, placebo-controlled trial including 140 patients (each with a unilateral NLDO) scheduled for nasolacrimal probing who were randomly assigned to receive MMC (0.2 mg/ml, 70 patients; group A) or placebo (normal saline, 70 patients; group B). Irrigation was carried out with 0.5 cc of MMC (0.2 mg/mL) in the duct with a nasal pack for 10 minutes in group A. Patients' postprobing epiphora was evaluated at 2 weeks and 1, 3, 6, and 9 months postoperatively. Probing was judged to be a success if there was no or mild watering for at least 9 months after the procedure. There were no significant differences between the two study groups in demographic characteristics or duration of the operation (p=0.062). The overall success rate of probing with MMC was 47/70 (67.1%), which was significantly higher than the success rate of the procedure with placebo (p=0.0027). When the sex of the patients was controlled for by logistic regression, a significant association between the failure rate of probing and increasing age was found in cases and controls (p=0.004 vs. p=0.006, respectively). No significant side effects of probing with MMC were noted after 9 months of follow-up. Administering MMC in a dosage of 0.2 mg/mL during nasolacrimal probing significantly increased the success rate of probing. The failure rate of probing increased with age. A low dose of MMC is cheap, safe, and easily accessible; thus, it is recommended during nasolacrimal probing, especially in patients who refuse dacryocystorhinostomy surgery.
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spelling pubmed-44069902015-04-24 Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial Dehghani, Nader Fouladivanda, Mohamad Reza Ghobadifar, Mohamed Amin Safshekan-Esfahani, Gelayol Akbarzadeh, Armin Chonnam Med J Original Article The current study aimed to determine the efficacy of probing with adjunctive mitomycin C (MMC) as a treatment for nasolacrimal duct obstruction (NLDO) in adults and to study the association of probing success with demographic and obstruction characteristics. This was a prospective, randomized, double-blind, placebo-controlled trial including 140 patients (each with a unilateral NLDO) scheduled for nasolacrimal probing who were randomly assigned to receive MMC (0.2 mg/ml, 70 patients; group A) or placebo (normal saline, 70 patients; group B). Irrigation was carried out with 0.5 cc of MMC (0.2 mg/mL) in the duct with a nasal pack for 10 minutes in group A. Patients' postprobing epiphora was evaluated at 2 weeks and 1, 3, 6, and 9 months postoperatively. Probing was judged to be a success if there was no or mild watering for at least 9 months after the procedure. There were no significant differences between the two study groups in demographic characteristics or duration of the operation (p=0.062). The overall success rate of probing with MMC was 47/70 (67.1%), which was significantly higher than the success rate of the procedure with placebo (p=0.0027). When the sex of the patients was controlled for by logistic regression, a significant association between the failure rate of probing and increasing age was found in cases and controls (p=0.004 vs. p=0.006, respectively). No significant side effects of probing with MMC were noted after 9 months of follow-up. Administering MMC in a dosage of 0.2 mg/mL during nasolacrimal probing significantly increased the success rate of probing. The failure rate of probing increased with age. A low dose of MMC is cheap, safe, and easily accessible; thus, it is recommended during nasolacrimal probing, especially in patients who refuse dacryocystorhinostomy surgery. Chonnam National University Medical School 2015-04 2015-04-14 /pmc/articles/PMC4406990/ /pubmed/25914876 http://dx.doi.org/10.4068/cmj.2015.51.1.19 Text en © Chonnam Medical Journal, 2015 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Dehghani, Nader
Fouladivanda, Mohamad Reza
Ghobadifar, Mohamed Amin
Safshekan-Esfahani, Gelayol
Akbarzadeh, Armin
Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial
title Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial
title_full Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial
title_fullStr Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial
title_full_unstemmed Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial
title_short Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial
title_sort nine-month follow-up results of treatment for nasolacrimal duct obstruction by probing with adjunctive mitomycin c in adults: a prospective randomized placebo-controlled trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406990/
https://www.ncbi.nlm.nih.gov/pubmed/25914876
http://dx.doi.org/10.4068/cmj.2015.51.1.19
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