Endoscopic DCR: A 10 Years Personal Experience

Abstract

Endoscopic DCR is an endonasal minimally invasive procedure to bypass an obstructed nasolacrimal duct by creating a direct fistula between the lacrimal sac and the nasal cavity. This is a retrospective case series review of the author's experience in endoscopic DCR in the period from 2007 to 2017. This series included 193 adult patients with a mean age of 47 years who underwent endoscopic DCR surgery. In this study, both primary and revision cases were reviewed including non-stented primary cases and bilateral simultaneous surgeries at the same session. Causes of failure in primary surgeries were stated, and indications of secondary cases were also reviewed. As a conclusion, endoscopic DCR remains the standard procedure in treating nasolacrimal duct obstruction with its consequent symptoms of epiphora, recurrent or chronic dacryocystitis.

The efficacy of endoscopic dacryocystorhinostomy in the treatment of dacryocystitis: A systematic review and meta-analysis

“…While punctal erosion and slitting of the canaliculi are 2 complications associated with stent implantation (EX-DCR). [ 30 ] In this study, the incidence of adverse events was much lower in the observation group than in the control group. This may be attributed to the higher risk of subsequent surgical failure brought on by longer recession time for EX-DCR, prolonged and recurrent infections, fistula formation, skin scar formation, and scar formation, adhesions, and granulation tissue within the lacrimal sac.…”

Efficacy of Hyaluronic Acid in Endoscopic Dacryocystorhinostomy: A Systematic Review and Meta-Analysis

“…7 Endoscopic DCR (Endo-DCR) was first described by McDonogh and has become increasingly popular over the external DCR approach due to less surgical trauma, shorter operation duration, low postoperative discomfort, and avoidance of external scar. [8][9][10] However, up to date, the efficacy of Endo-DCR for the treatment of CD is still unsatisfactory with a reported success rate ranging from 82% to 95%. [10][11][12][13] Although several surgical techniques have been developed over the years to promote the efficacy of En-DCR, ranging from producing the nasal mucosal and lacrimal sac flaps, varying the size of the bony ostium, silicone tube intubation, none have been shown to significantly increase En-DCR success rates.…”

“…[8][9][10] However, up to date, the efficacy of Endo-DCR for the treatment of CD is still unsatisfactory with a reported success rate ranging from 82% to 95%. [10][11][12][13] Although several surgical techniques have been developed over the years to promote the efficacy of En-DCR, ranging from producing the nasal mucosal and lacrimal sac flaps, varying the size of the bony ostium, silicone tube intubation, none have been shown to significantly increase En-DCR success rates. [14][15][16] Reasons for failure after Endo-DCR include restenosis and obstruction of the rhinostomy by granulation tissue or synechia that form postoperatively.…”