Surgical Outcome of Repeat External Dacryocystorhinostomy with or Without Mitomycin C for Previously Failed Dacryocystorhinostomy: A Comparative Study of Eastern Nepal

Abstract

INTRODUCTION: Dacryocystorhinostomy including use of antimetabolites as Mitomycin-C can increase the success rate of surgery for nasolacrimal duct obstruction. Therefore, this study is aimed to compare the surgical outcome of Dacryocystorhinostomy with and without intraoperative use of 0.02% Mitomycin-C in the treatment of failed external Dacryocystorhinostomy surgery.

METHOD: This is a retrospective quasi-experimental study done at Biratnagar Eye hospital from January 2018 to January 2021. We included all 60 failed cases of external Dacryocystorhinostomy previously operated inside the hospital and at other hospitals. The patients underwent External Dacryocystorhinostomy with 0.02 % Mitomycin-C in one group and the External Dacryocystorhinostomy without Mitomycin-C in another group. There were 30 eyes in each group, 60 in total. We used an independent sample t-test, chi-square test and fisher exact test as statistical methods for the data analysis

RESULT: At the end of 12 months 96.7% had success in Dacryocystorhinostomy with the Mitomycin-C group and 93.3% had success in the Dacryocystorhinostomy without Mitomycin-C group. On the other hand, there was 3.3% failure in Dacryocystorhinostomy with Mitomycin-C group and 6.7% failure in Dacryocystorhinostomy without Mitomycin-C group.

CONCLUSION: Although the success rates did not reach statistical significance, slightly higher success has been achieved in patients undergoing Dacryocystorhinostomy with Mitomycin C group. Thus it can be concluded that intraoperative use of Mitomycin-C improves the success rate of revision Dacryocystorhinostomy surgery without any detrimental effects and hence can be considered as a safe and effective modification of conventional Dacryocystorhinostomy.