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Epiphora as a side effect of topical mitomycin C

St Erik’s Eye Hospital, Karolinska Institutet, Polhemsgatan 50, S-112 82 Stockholm, Sweden

Correspondence to:
Correspondence to:
Eva Dafgård Kopp
St Erik’s Eye Hospital, Karolinska Institutet, Polhemsgatan 50, S-112 82 Stockholm, Sweden; eva.dafgard{at}sankterik.se

ABSTRACT
Aim: To report symptoms and findings of lacrimal duct malfunction after topical mitomycin C (MMC) for conjunctival neoplasia.

Methods: 14 consecutive patients treated with 1–6 cycles of topical 0.04% MMC four times daily for periods of 2 weeks were interviewed about symptoms of lacrimal duct malfunction. Patients who complained of tearing had examination of the puncta and canaliculi including probing and lacrimal duct irrigation.

Results: Nine patients complained of epiphora after topical MMC. Three of these patients had normal puncta and canaliculi, patent to irrigation. In these patients epiphora ceased spontaneously after probing and irrigation. The additional six patients had stenosis of the punctum (n = 3), the common canaliculus (n = 1), both puncta and both canaliculi (n = 1) and complete occlusion of the lower canaliculus (n = 1).

Conclusion: Obstruction of the puncta or canaliculi is not an infrequent event after topical 0.04% MMC.

Abbreviations: CCIN, conjunctival corneal intraepithelial neoplasia; MMC, mitomycin C; PAM, primary acquired melanosis; SCC, squamous cell carcinoma

Keywords: epiphora; mitomycin C; lacrimal duct; stenosis

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