Vol. 7, Issue 1, Part A (2025)

Objective: Nasolacrimal duct obstruction (NLDO) can cause epiphora which is a very common condition with numerous etiologies. The clinical spectrum of epiphora ranges from the occasionally trickle to chronically irritating overflow of tears. Dacryocystorhinostomy (DCR), is the treatment of choice for NLDO. It can be performed through a cutaneous incision, referred to as external DCR (EX-DCR), or via a transnasal approach referred to as endonasal DCR (EN-DCR). The purpose of the current study was to evaluate the functional & anatomic success as well as operative time, adverse events, success rates and patient satisfaction for EX-DCR and EN-DCR procedures.

Material and Methods: This retrospective observational study included, 68 patients who undergone EX-DCR by an ophthalmologist & 53 patients who undergone EN-DCR by an otorhinolaryngologist from 1st September 2023 to 30^th July 2025. Data was collected including age, gender, ocular history, pre-op & post-op eye examination, operative time, adverse events, follow-up time, patient satisfaction and success. SPSS program was used for the statistical analysis.

Results: A total of 121 patients were included in the study, out of which 68 patients were undergone EX-DCR surgery while 53 patients were undergone EN-DCR surgery. The demographic characteristics of our patient population were statistically similar in both groups. Our findings showed a high and comparable success rate of both approaches, with anatomical success of 88.23% in EX-DCR group and 88.67% in EN-DCR group while functional success was achieved by 76.47% in EX-DCR group and 77.35% in EN-DCR group. We found relatively higher rate of complication in EX-DCR compared to EN-DCR without any serious complications. Consistent with the literature we found that EN-DCR surgery is quicker than the EX-DCR surgery. Patient satisfaction was also significantly higher in the EN-DCR group

Conclusion: This study suggests that both procedures have a high success rate and are almost equivalent in producing symptomatic relief of epiphora. The shorter duration of surgery, absence of any visible scar along with equivalent success rates to EX-DCR, make EN-DCR a highly attractive procedure for the treatment of NLDO.