Dacryoendoscopy: Historical development, philosophical foundation, and clinical perspective.

Area of Science:

• Ophthalmology
• Surgical Innovation
• Medical Device Technology

Background:

• Epiphora management has historically faced challenges with diagnostic accuracy and treatment invasiveness.
• Dacryoendoscopy has evolved over 30 years, enhancing understanding of lacrimal outflow pathology.
• A paradigm shift from blind intervention to anatomy-based diagnosis and management is evident in lacrimal surgery.

Purpose of the Study:

• To review the evolution, device philosophy, and clinical applications of dacryoendoscopy.
• To highlight the contributions of the Bent group and the rise of conservative minimally invasive lacrimal surgery.
• To discuss techniques and challenges in dacryoendoscopy for nasolacrimal duct obstruction.

Main Methods:

• Narrative review of relevant literature.
• Nonsystematic search of PubMed and Ichushi-Web (1995-2025).
• Keywords: dacryoendoscopy, nasolacrimal duct, false passage.

Main Results:

• Dacryoendoscopy enhances diagnostic precision and enables minimally invasive treatment for epiphora.
• Bent probe endoscopes are widely used, particularly in Asia.
• Techniques like sheath-guided probing and intubation were reviewed, with false passage identified as a complication.

Conclusions:

• Dacryoendoscopy represents a significant advancement in lacrimal surgery, emphasizing visualization before intervention.
• Conservative, mucosa-preserving techniques are emerging, especially for pediatric cases.
• Long-term outcome deterioration and mucosal regeneration remain challenges in dacryoendoscopy.