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Dacryocystorhinostomy (DCR) is a surgical procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function.Endoscopic laser dacryocystorhinostomy (DCR) enables an obstructed lacrimal sac to be opened through an intranasal approach, avoiding the need for a skin incision.

The operation can also be performed endoscopically through the nose where an opening is fashioned in the lacrimal sac from within the nose. Newer techniques and advances in endoscopic surgery has increasingly made this approach the procedure of choice. The advantages include lesser peri-operative morbidity, no scar and a high success rate. Even revision surgery done by the endoscopic route is easier.

With the advent of nasal endoscopes endoscopic dacryocystorhinostomy is becoming popular. In this procedure a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. The bone covering the lacrimal sac is nibbled out. The medial wall of the sac is excised facilitating drainage of tears into the nasal cavity. This procedure avoids scar.

The endoscopic approach has several advantages, including the following:

• It provides a better aesthetic result with no external scar.
• It allows a one-stage procedure to also correct associated nasal pathology that may be causative.
• It avoids injury to the medial canthus and/or pathologic scar formation.
• It is much less bloody and messy than the external approach.
• The success rate is comparable to the external approach.