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Advances in lacrimal surgery.

¹Department of Ophthalmology & Visual Sciences, University of Illinois Eye & Ear Infirmary, Chicago 60612, USA. mtd@uic.edd

Current Opinion in Ophthalmology

|January 10, 2001

Summary

Dacryocystorhinostomy (DCR) remains the gold standard for epiphora and nasolacrimal duct obstruction. While newer techniques show promise, external DCR offers advantages in ease and cost, with evolving antibiotic protocols for infection prevention.

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Area of Science:

Ophthalmology
Otorhinolaryngology

Background:

Dacryocystorhinostomy (DCR) has been the primary surgical treatment for epiphora and nasolacrimal duct obstruction for nearly a century.
Conjunctivodacryocystorhinostomy is the definitive treatment for severe canalicular strictures.

Purpose of the Study:

To compare the efficacy and practical considerations of traditional external DCR with newer endocanalicular and endonasal approaches.
To evaluate the role and optimal timing of antibiotic administration in preventing surgical site infections.

Main Methods:

Review of literature comparing outcomes, ease of performance, and economic impact of external DCR versus minimally invasive techniques.
Analysis of current evidence regarding the use of intraoperative versus postoperative antibiotics for infection prophylaxis.

Main Results:

External DCR maintains a high success rate and is often favored for its simplicity and lower cost.
Endocanalicular and endonasal DCR techniques demonstrate comparable outcomes to external DCR, narrowing the performance gap.
Intraoperative antibiotic administration may be as effective as postoperative systemic antibiotics in high-risk patients.

Conclusions:

External DCR remains a reliable and cost-effective treatment for nasolacrimal duct obstruction.
Minimally invasive DCR techniques are advancing, offering viable alternatives with similar success rates.
Antibiotic strategies for DCR surgery are evolving, with intraoperative dosing showing potential efficacy.

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