Evaluation of intraoperative mitomycin C in surgical management of adult lacrimal sac mucocele

Abstract

Purpose The purpose of this study was to evaluate the effectiveness of intraoperative mitomycin C (MMC) with canaliculodacryocystorhinostomy (DCR) and bicanalicular silicone intubation for the management of adult lacrimal sac mucocele. Patients and methods In a 3-year period, 30 eyes of 28 adult patients with acquired lacrimal sac mucocele were enrolled in the study after thorough evaluation and if required computed tomography imaging was taken. All patients had at least 8 mm of patent proximal canaliculi. Under general anesthesia, all patients underwent canaliculo-DCR with bicanalicular silicone intubation and intraoperative MMC 0.2 mg/ml solution applied for 5 min to the lacrimal passages. All patients were followed up for at least 12 months postoperatively. Results The mean age of the patients was 48.90±12.28 years and 78.6% of the cases were women. After a follow-up period of an average of 16 months, 93.3% of the patients reported successful results (disappearance of epiphora and lacrimal sac swelling and patent lacrimal passages) and only 6.7% presented with recurrent epiphora and obstructed lacrimal passages. No case of recurrent lacrimal sac mucocele was reported. Conclusions Canaliculo-DCR with bicanalicular silicone intubation and intraoperative MMC yielded satisfactory results in 93.3% of adult patients with acquired lacrimal sac mucocele.

Keywords

• acquired
• adult
• canaliculodacryocystorhinostomy
• mitomycin c
• mucocele