Role of Mitomycin C in Primary Partial Nasolacrimal Duct Obstruction In A Pakistani Cohort at A Tertiary Care Hospital of Karachi

Doi: 10.36351/pjo.v42i3.2155

Abstract

Purpose:To assess improvement in epiphora after probing and syringing with diluted Mitomycin C in cases of primary partial NLDO at a tertiary care hospital of Karachi.

Study Design:Quasi Experimental study.

Place and Duration of Study:Isra Postgraduate Institute of Ophthalmology from January 2025 to June 2025.

Methods:Fifty patients diagnosed with primary acquired nasolacrimal duct obstruction (PANDO), aged above 18 years and of either gender, were included in the study. Probing was performed under local anesthesia using 0.5% proparacaine topical drops, followed by infiltration of 2% xylocaine with adrenaline around the medial canthus and beneath the periosteum. Patency was confirmed by syringing with normal saline. Subsequently, irrigation was conducted using 1 mL of mitomycin-C (0.2 mg/mL, single application), and nasal packing was maintained for 10 minutes to minimize systemic absorption. Follow-up examinations were conducted at 1 week, and then at 1, 2, and 3 months post-procedure.

Results: Of the 50 patients, 35 (70%) were female and 15 (30%) were male, with a mean age of 34.56 ± 6.88 years. The majority presented with grade 2 obstruction (n = 25, 50%), followed by grade 3 (n = 20, 40%). At the first-week follow-up, 8 (16%) patients showed mild improvement, 12 (24%) demonstrated moderate improvement, and 20 (40%) achieved complete relief of epiphora.

Conclusion: Probing with adjunctive mitomycin-C is a simple, cost-effective, and efficacious procedure for relieving epiphora secondary to nasolacrimal duct obstruction. It may delay the need for dacryocystorhinostomy (DCR)for a considerable period.