A critical update on endoscopic dacryocystorhinostomy.

Area of Science:

• Ophthalmology
• Otorhinolaryngology

Background:

• Endoscopic dacryocystorhinostomy (endo-DCR) is increasingly utilized for distal lacrimal duct obstruction.
• It offers comparable success rates to external DCR without visible scarring.
• However, optimal indications, techniques, and perioperative management require further clarification.

Purpose of the Study:

• To systematically review the recent literature on endoscopic dacryocystorhinostomy.
• To identify current trends, technical modifications, and areas of uncertainty in endo-DCR.

Main Methods:

• Systematic literature review of studies published in the last 5 years.
• Searches conducted using PubMed and Google Scholar databases.
• Inclusion of 66 relevant articles.

Main Results:

• Numerous technical modifications and refinements in endo-DCR have been reported.
• Methodological heterogeneity hinders direct comparison of different surgical techniques.
• Use of local anesthesia and adjunctive techniques to prevent restenosis are emerging but lack strong evidence.

Conclusions:

• Endo-DCR demonstrates satisfactory clinical outcomes for lacrimal duct obstruction.
• Significant knowledge gaps persist regarding indications, techniques, and perioperative care.
• High-quality studies are necessary to address these uncertainties and optimize endo-DCR practice.