EFFICACY AND SAFETY OF ENDOSCOPIC DACRYOCYSTORHINOSTOMY IN PATIENTS WITH NASOLACRIMAL DUCT OBSTRUCTION: EXPERIENCE AT TERTIARY CARE HOSPITAL, PESHAWAR

Objective: To determine the safety and efficacy of Endoscopic Dacryocystorhinostomy in patients with nasolacrimal duct obstruction. Methods: The prospective non-randomized non-comparative observational study was conducted at Department of Ear Nose Throat and Head & Neck Surgery, Khyber Teaching Hospital, Peshawar, from June 2024 to May 2025 and observed patients of acute/ chronic dacryocystitis, who underwent endoscopic endonasal dacryocystorhinostomy, for the outcome of procedure. Endoscopic dacryocystorhinostomy (DCR), with or without the use of lacrimal intubation, was carried out under general anesthesia. The patients were followed up post-operatively at 1 month and 6 months. Data was analyzed using SPSS 24. Results: A total 54 eyes of 50 patients (56% males) underwent endoscopic dacryocystorhinostomy, with mean age of 37.3 ± 12.12years. Primary procedures were performed in 90% patients and 10% were revision cases. Unilateral surgeries accounted for 92%, with stents used in 44% of eyes. Mean operative time was 61.5 ± 40.6minutes. Concurrent nasal procedures were done in 22%.Post-operatively, patients were discharged within/ after 12 hours. At six-month follow-up, both anatomical and functional success were achieved in 96% of patients. Recurrent dacryocystitis occurred in 4% patients. Significant intra-operative bleeding was seen in 6%, with no major complications reported. Conclusion: Endoscopic DCR is a safe and effective surgical option for nasolacrimal duct blockade. The use of stents is primarily determined by the anatomical site of the obstruction. Bilateral cases can be treated simultaneously, with outcomes and success rates similar to those of unilateral procedures.