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Infantile Endoscopic Dacryocystorhinostomy: Indications, Anatomical Considerations, and Outcomes

The purpose of this case series is to report the demographic profile, indications, anatomical considerations, and outcomes of Endonasal endoscopic DCR in the infants. Five eyes of 3 infants underwent IEnDCR with a mean age of 4.26 months (range: 23 days–8 months). There were 2 males and 1 female. Two of the infants underwent bilateral surgery. The indication for surgery in the infant undergoing unilateral surgery was recurrent acute dacryocystitis and lacrimal abscess formation secondary to refractory and complex congenital nasolacrimal duct obstruction. Infants undergoing bilateral lacrimal surgery had refractory complex congenital nasolacrimal duct obstruction and were in need for an early intraocular surgery for associated ocular morbidities. Mitomycin-C (0.02% for 3 minutes) and silicone intubation was used in all cases. At follow up of 9 months, all the 3 infants demonstrated anatomical and functional success. The surgical technique requires certain modifications in order to cater to the unique challenges. It is safe and effective in experienced hands and can be considered as an alternative to an external DCR in infants. Endonasal endoscopic dacryocystorhinostomy in infants is a safe and effective technique in experienced hands for limited and specific set of indications.