Eshraghy Bahram, Raygan Firoozeh, Tabatabaie Syed Ziaeddin, Tari Ali Sadeghi, Kasaee Abolfazl, Rajabi Mohammad Taher
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Eur J Ophthalmol. 2012 May-Jun;22(3):326-9. doi: 10.5301/ejo.5000007.
To assess the effect of mitomycin C on surgical success rate of dacryocystorhinostomy and silicone intubation in patients with improper flaps.
The study was a randomized clinical trial. The patients with indication for dacryocystorhinostomy surgery with silicone intubation (inappropriate lacrimal sac or nasal mucosal flaps during surgery and/or history of dacryocystitis in the past 3 months) were randomly assigned to application of mitomycin C (0.02%) on surgical flaps (group A) or a control group without mitomycin C application (group B). Main outcome measures were subjective symptomatic improvement and result of irrigation test at last follow-up visit.
The study enrolled 88 patients (88 eyes); there were 42 patients in group A and 46 patients in group B. There was an average follow-up of 10 months (range 6-15 months) following surgery. Significant improvement (no tearing with patent lacrimal system in irrigation) was observed in 31 patients (73.8%) in group A and 32 patients (69.6%) in group B. There was no statistically significant difference in no improvement (no change in tearing state and obstruction in irrigation test), relative improvement (decreased tearing and passage of fluid with force in irrigation test), and significant improvement rate between the 2 groups of study (p>0.05).
Application of mitomycin C on surgical flaps during dacryocystorhinostomy surgery with silicone intubation in patients with improper flaps has no proven beneficial effect on success rate of surgery.
评估丝裂霉素C对泪囊鼻腔吻合术联合硅胶管植入术治疗皮瓣异常患者手术成功率的影响。
本研究为一项随机临床试验。将有泪囊鼻腔吻合术联合硅胶管植入术指征（手术中泪囊或鼻黏膜皮瓣异常和/或过去3个月内有泪囊炎病史）的患者随机分为两组，A组在手术皮瓣上应用丝裂霉素C（0.02%），B组为未应用丝裂霉素C的对照组。主要观察指标为末次随访时的主观症状改善情况及冲洗试验结果。
本研究共纳入88例患者（88只眼）；A组42例，B组46例。术后平均随访10个月（范围6 - 15个月）。A组31例患者（73.8%）和B组32例患者（69.6%）观察到显著改善（冲洗时泪道通畅无流泪）。两组在未改善（流泪状态无变化且冲洗试验有阻塞）、相对改善（流泪减少且冲洗试验时用力可通过液体）及显著改善率方面无统计学显著差异（p>0.05）。
对于皮瓣异常的患者，在泪囊鼻腔吻合术联合硅胶管植入术中在手术皮瓣上应用丝裂霉素C对手术成功率未显示出有益作用。
