Endoscopic Dacryocystorhinostomy with Transcanalicular Illumination: How We Do It

Background Endoscopic dacryocystorhinostomy (endo-DCR) has increasingly replaced the external approach in many centers because it avoids cutaneous scarring and provides improved intranasal visualization. Accurate intraoperative identification of the lacrimal sac remains a critical determinant of surgical success. Transcanalicular illumination has been introduced as an adjunctive technique to facilitate precise localization of the lacrimal sac during endoscopic DCR. Objective To describe the surgical technique and short-term outcomes of endoscopic dacryocystorhinostomy assisted by transcanalicular illumination in patients with primary nasolacrimal duct obstruction. Methods This retrospective descriptive case series included 22 patients with primary nasolacrimal duct obstruction who underwent endoscopic DCR assisted by transcanalicular illumination. Demographic data, laterality, intraoperative findings, complications, and postoperative outcomes were analyzed. No comparative group was included. Results The mean patient age was 56.61 ± 8.21 years (range 25–73 years). Nasolacrimal duct obstruction was right-sided in 68.2% and left-sided in 31.8% of patients. Primary resolution of epiphora was achieved in 21 of 22 patients (95.4%). One patient required revision surgery due to lower canalicular obstruction, after which symptom resolution was achieved. No major intraoperative or postoperative complications were observed during the follow-up period. Conclusion Endoscopic dacryocystorhinostomy assisted by transcanalicular illumination was technically feasible and demonstrated favorable short-term outcomes in this retrospective case series. The technique facilitated intraoperative localization of the lacrimal sac without major complications. These findings are descriptive and should be interpreted within the limitations of a small, non-comparative study. Prospective controlled studies with longer follow-up are required to determine long-term effectiveness and comparative outcomes.