Dacryocystorhinostomy (DCR) is widely recognised as the gold-standard surgical intervention for managing nasolacrimal duct obstruction, particularly when medical therapy fails to restore adequate lacrimal drainage. Both external and endonasal (endoscopic) DCR approaches have evolved considerably over recent decades, with technological advancements and refinements in technique contributing to improved patient outcomes.
Internationally, there is notable variation in practice patterns, including the choice of surgical approach, perioperative management, and the use of adjuncts such as intraoperative stenting or topical mitomycin-C. These differences are influenced by local expertise, healthcare infrastructure, and evolving evidence regarding efficacy and complication profiles.
Recent comparative studies suggest similar success rates for both external and endonasal DCR, with growing acceptance of minimally invasive techniques in some regions. Nevertheless, challenges remain regarding standardisation of indications, postoperative care, and criteria for surgical success. Despite the expanding global adoption of DCR, there is a paucity of consolidated international data mapping current clinical practices, training trends, and perioperative protocols.
Therefore, the aim of this survey is to elucidate contemporary international practices in DCR surgery, exploring variation in technique, perioperative management, and outcome measures. Insights garnered will inform consensus guidelines, facilitate global benchmarking, and highlight priorities for future research.
