Abstract

A COMPARATIVE STUDY OF DCR SURGERY WITH AND WITHOUT INTRA-OPERATIVE APPLICATION OF MITOMYCIN C IN TERTIARY CARE CENTRE OF JHARKHAND

Dr. Rashmi Tirkey*, Dr. Marianus Deepak Lakra, Dr. C. Lalhmingmawii, Dr. Mugdha Sumati

ABSTRACT

Background: Chronic dacryocystitis is commonly caused by nasolacrimal duct obstruction and is effectively treated by external dacryocystorhinostomy (DCR). Postoperative fibrosis may reduce surgical success. Intraoperative application of mitomycin-C (MMC), an antifibrotic agent, has been proposed to improve DCR outcomes. Objective: To compare the outcomes of external dacryocystorhinostomy (DCR) performed with and without intraoperative mitomycin-C (MMC). Methods: This prospective, hospital-based comparative study was conducted in the Department of Ophthalmology, Rajendra Institute of Medical Sciences, Ranchi, between September 2023 and August 2024. A total of 46 patients with chronic dacryocystitis were equally allocated to undergo either external DCR with intraoperative MMC (n = 23) or conventional external DCR without MMC (n = 23). Patients were evaluatedpostoperatively at 1 week, 1 month, 3 months, 6 months, and 12 months. Surgical success was determined by the resolution of epiphora and confirmation of lacrimal drainage patency on syringing. Results: Demographic and clinical details were comparable between the two groups. At the 12-month follow-up, persistent postoperative epiphora was observed in only 4.3% of patients in the DCR with MMC group compared with 30.4% in the conventional DCR group. Lacrimal drainage patency on syringing was achieved in 95.7% of patients who received intraoperative MMC, whereas the success rate was 69.6% in the conventional DCR group. Conclusion: Intraoperative mitomycin-C significantly improved the anatomical and functional success of external DCR by reducing postoperative fibrosis and maintaining ostium patency. MMC appears to be a safe and effective adjunct to external DCR in patients with chronic dacryocystitis.

Keywords: Chronic dacryocystitis, dacryocystorhinostomy, mitomycin-C, nasolacrimal duct obstruction, epiphora, external DCR.