Efficacy of probing adjunctive with low dose Mitomycin-C irrigation for treatment of epiphora in adults with nasolacrimal duct stenosis

Purpose: To investigate the efficacy of adjunctive low-dose mitomycin-C (MMC) during successful lacrimal duct probing in adults with nasolacrimal ducts stenosis.Methods: In this interventional study, 73 eyes of 58 patients with nasolacrimal duct (NLD) stenosis were randomized in 2 groups. All patients underwent probing without or with application of MMC. Former group receiving 0.2 mg/ml MMC irrigation for 5 minutes. Main Outcome measures were; objective evaluation of patency with irrigation, as well as patients’ subjective assessment of improvement. Results: Patients ages ranged from 19 to 78 years (mean 44 years). After mean follow-up interval of 9 months, 23 (60%) of the 38 eyes in the MMC groups and 8(22%) of the 35 eyes in control group had complete response and remained symptom free .This difference was statistically significant (P=0.005). According to patient’s satisfaction, epiphora was partially improved in 6(17%) eyes of control group and 4(10%) eyes in MMC group. The success rate for application of MMC was better in patients with severe stenosis (P=0.007), Patients who had symptoms more than 12 months (P=0.02) and patients with constant epiphora compared with intermittent symptoms (P=0.001). No complications were detected during patients follow-up. Conclusion: This study suggests acceptable long-term results for probing adjunctive with topical MMC for adult with NLD stenosis. This technique can be recommended as a simple and effective procedure for these patients.