Abstract:

Objective   To assess the efficacy of mitomycin C (MMC), 5-Fluorouracil and sodium hyaluronate in dacryosystorhinostomy (DCR) for chronicity dacryocystisis.Methods   One hundred and fifty-five cases (one hundred and sixty-six eyes) of chronicity dacryocystisis were randomly divided into the mitomycin C group, the 5-Fluorouracil group, the sodium hyaluronate group and the control group. The surgical procedures were exactly the same except that 0.4mg/mL mitomycin C, 50mg／mL 5-Fluorouracil, 10mg/m sodium hyaluronate were used in the three groups, and in the control group, the dacryosystorhinostomy procedures were employed . All the cases were followed up for 12 months. The condition of lacrimal passages was observed, area of orificium fistulae was measured by endoscopes, and the recovery of the nasal cavity was monitored. Results   (1) In the four groups: the recovery rate in test team (43/44 eyes(97.7%) in the mitomycin C group, 35/38 eyes ( 92.1%) in the 5-Fluorouracil group, 40/44 eyes (90.9%) in the sodium hyaluronate group) was obviously higher than that in the control group(35/40 eyes ( 87.5%)) with a statistically significant difference between the test groups and the control group(χ2=5.62, P=0.019; χ2=7.84，P=0.029; χ2=5.78, P=0.016). (2) The difference of area of the orificium fistulae between the test groups and the control group showed statistical significance in 6 months after the operation(F=6.096, P=0.006), but showed no statistical significance in the three test groups(P=0.564). The area of the orificium fistulae between the test groups and the control group showed statistical significance (F=6.162, P=0.002). The area of the orificium fistulae in the mitomycin C group was bigger than that in the 5-Fluorouracil group, and the difference had statistical significance (P=0.022). The area of the orificium fistulae in the mitomycin C group was bigger than the sodium hyaluronate group, and the difference was statistical significance (P=0.034). There was no statistical significance(P=0.719) between the 5-Fluorouracil group and the sodium hyaluronate group. Conclusion   Drugs used in dacryocystorhinostomy can increase the recovery rate, and mitomycin C is better than 5-Fluorouracil and sodium hyaluronate.

Key words:  Dacryocystitis; Dacryocystorhinostomy; Mitomycin C; 5-F1uorouracil; Sodium hyaluronia