[Current status of dacryocystorhinostomy]

Abstract

The history of the treatment of lacrimal duct stenosis dates back to the ancient world. Modern lacrimal duct surgery began with the description of external dacryocystorhinostomy (DCR) by Toti and the endonasal procedure by West. Modifications include construction of a mucous membrane flap and the use of different instruments such as microscopes, endoscopes, and laser. This article reviews the various methods currently in use, although the analysis makes clear how difficult it is to compare studies. Because of the high success rate and the possibility of correcting multiple disturbing factors of the lacrimal drainage system, external DCR remains the gold standard for the ophthalmologist; other methods must be measured by the success rate of external DCR. The future of lacrimal duct surgery lies in a better understanding of wound healing and thus the possibility for precise modulation. Better results may be possible by combining different surgical methods. Prospective studies are urgently necessary.