Effect of mitomycin C on the outcome of transcanalicular laser dacryocystorhinostomy

• Author Details:   
• Abir Bin Sajj ^*
• Tohura Sharmin
• Abid Akbar
• Siddiqur Rahman
• Md. Adnan Islam
• Md. Tangil Ahmed
• Md. Ariful Islam

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Aim and Objective: This study aimed to evaluate the efficacy of Mitomycin C (MMC) as an adjunctive therapy in transcanalicular laser-assisted dacryocystorhinostomy (DCR) for the management of nasolacrimal duct obstruction (NLDO), comparing outcomes with procedures performed without MMC.
Introduction: Nasolacrimal duct obstruction (NLDO) is a common condition often requiring surgical intervention, with dacryocystorhinostomy (DCR) being the gold standard treatment. Transcanalicular laser-assisted DCR has emerged as a minimally invasive alternative, though postoperative fibrosis and ostium closure remain significant challenges. Mitomycin C (MMC), an antiproliferative agent, has shown potential in improving surgical outcomes by reducing scar tissue formation.
Materials and Methods: A prospective, comparative analysis was conducted on 189 patients who underwent transcanalicular laser DCR between 2022 and 2024 in Vision Eye Hospital, Dhaka, Bangladesh. Patients were divided into two groups: 103 received intraoperative MMC (0.5 mg/mL applied for 5 minutes), while 86 underwent surgery without MMC. All procedures were performed under local anesthesia using a diode laser, with bi-canalicular silicone stents placed and removed after one month. Success was defined as the absence of epiphora and patent lacrimal irrigation during follow-up (up to one year). Statistical analysis was performed using SPSS version 26, with p<0>
Result: The success rate was significantly higher in the MMC group (91.3%, 94/103) compared to the non-MMC group (80.2%, 69/86; p=0.03). Postoperative complications, such as fibrosis and granulation tissue formation, were less frequent in the MMC group. Demographic characteristics (age, gender) were comparable between groups (p>0.05).
Conclusion: Adjunctive use of MMC in transcanalicular laser DCR significantly improves surgical success rates by reducing postoperative scarring. In light of the study outcome we recommend MMC to be used as an adjunctive therapy in transcanalicular laser-assisted DCR surgery for better success rate. Further prospective studies with longer follow-up are warranted to validate these results.

Keywords: Dacryocystorhinostomy, Mitomycin C, Transcanalicular laser DCR, Nasolacrimal duct obstruction.