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Updated: Dec 27, 2025
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Infantile Endoscopic Dacryocystorhinostomy: Indications, Anatomical Considerations, and Outcomes
Nandini Bothra1, Varshitha Hemanth Vasanthapuram, Mohammad Javed Ali
1Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India.
Insights
Endonasal endoscopic dacryocystorhinostomy (DCR) is a safe and effective treatment for complex congenital nasolacrimal duct obstruction in infants. This case series shows high success rates, offering an alternative to external DCR.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Otolaryngology
Background:
- Congenital nasolacrimal duct obstruction (CNLDO) can be complex and refractory.
- Infants may require early intervention for CNLDO, especially with associated ocular morbidities.
- Endonasal endoscopic dacryocystorhinostomy (DCR) presents a minimally invasive surgical option.
Purpose of the Study:
- To report the demographic profile, indications, and outcomes of endonasal endoscopic DCR in infants.
- To evaluate the safety and efficacy of the IEnDCR technique in pediatric patients.
- To highlight anatomical considerations and necessary modifications for infant surgery.
Main Methods:
- A case series of 3 infants (5 eyes) undergoing IEnDCR.
- Mean age of 4.26 months; procedures included unilateral and bilateral surgeries.
- Mitomycin-C and silicone intubation were used in all cases.
Main Results:
- All 3 infants achieved anatomical and functional success at a 9-month follow-up.
- Indications included recurrent acute dacryocystitis, lacrimal abscess, and CNLDO.
- The technique was deemed safe and effective in experienced hands.
Conclusions:
- IEnDCR is a viable and effective alternative to external DCR for infants with complex CNLDO.
- Surgical technique modifications are essential for pediatric anatomical challenges.
- The procedure demonstrates excellent outcomes in experienced surgical teams.
Abstract:
The purpose of this case series is to report the demographic profile, indications, anatomical considerations, and outcomes of Endonasal endoscopic DCR in the infants. Five eyes of 3 infants underwent IEnDCR with a mean age of 4.26 months (range: 23 days-8 months). There were 2 males and 1 female. Two of the infants underwent bilateral surgery. The indication for surgery in the infant undergoing unilateral surgery was recurrent acute dacryocystitis and lacrimal abscess formation secondary to refractory and complex congenital nasolacrimal duct obstruction. Infants undergoing bilateral lacrimal surgery had refractory complex congenital nasolacrimal duct obstruction and were in need for an early intraocular surgery for associated ocular morbidities. Mitomycin-C (0.02% for 3 minutes) and silicone intubation was used in all cases. At follow up of 9 months, all the 3 infants demonstrated anatomical and functional success. The surgical technique requires certain modifications in order to cater to the unique challenges. It is safe and effective in experienced hands and can be considered as an alternative to an external DCR in infants.
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