Journal of Clinical and Experimental Ophthalmology
Open Access

Role of Mitomycin-C in treatment of Recurrent lacrimal punctum occlusion

lnternational Conference on Eye Disorders and Treatment

July 13-15, 2015 Baltimore, USA

Doaa Hegazy

Posters-Accepted Abstracts: J Clin Exp Ophthalmol

Abstract :

Purpose: To evaluate the role of Mitomycin-C in treatment of recurrent lacrimal punctum occlusion during the procedure of posterior punctectomy and lacrimal intubation. Design: Non-randomized prospective study Methods: This non-randomized prospective study was held at Al Zahraa University Hospital between March 2012 and December 2012 it included 10 eyes in 8 patients (3 Males, 37.5 % and 5 Females, 62.5%). Their mean age and SD was 47.3+11.2 years (Range: 23- 63 years). All cases had epiphora secondary to recurrent punctal occlusion; eight cases (80%) had a past history of lacrimal probing (twice in 5 cases and once in 3 cases). One case (10%) had a history of lacrimal probing and lacrimal intubation and one case (10%) had a history of laser punctoplasty. Upper and lower puncti occlusion was reported in 7 cases (70%), while lower punctum occlusion alone was reported in 3 (30%) cases. The etiology of punctum obstruction was unknown in 4 cases (40%), anti-glaucoma medications in 3 cases (30%), post cataract surgery in 1 case (10%) and I131 in bilateral case (20%). Results: This non-randomized prospective study included 10 eyes in 8 patients (3 Males, 37.5 % and 5 Female, 62.5%). Their mean age and SD was 47.3+11.2 years (Range: 23-63 years). All cases had epiphora secondary to recurrent punctal occlusion. Eight cases (80%) had a past history of punctum dilatation (twice in 5 cases and once in 3 cases). One case (10%) had a history of lacrimal probing with lacrimal intubation and one case (10%) had a history of laser punctoplasty. Upper and lower puncti occlusion was reported in 7 cases (70%), while lower punctum occlusion alone was reported in 3 (30%) cases. Three cases (30%) were receiving topical anti-glaucoma therapy; bilateral eyes in patients with a history of radioactive I131 uptake 8 months earlier for treatment of thyroid carcinoma (20%) and one patient had epiphora after cataract surgery (10%). All cases had a history of previous surgical interference to correct punctum occlusion. History of previous punctum dilatation was reported in 8 cases, 4 to 24 weeks before the procedure of posterior punctectomy. Laser punctoplasty was reported in 1 case, 12 weeks before our study. Failed lacrimal probing and lacrimal intubation was reported in 1 case (1 year before the procedure of posterior punctectomy. Postoperative symptom free cases were reported in 6 cases (60%), interrupted epiphora in 3 cases (30%), while continuous epiphora in 1 cases (10%). Improvement of epiphora (at the last follow up visit) was reported in 9 cases (90%), while no improvement was reported in 1 case (10%). Conclusion: Posterior punctectomy supplemented by intra-operative Mitomycin-C application and lacrimal intubation for treatment of recurrent punctal occlusion minimizes adhesions and scar tissue around the new opening; therefore it is a major factor in improving surgical outcome.