Dacryocystorhinosotomy (DCR) surgery has been traditionally performed via an external approach under general anaesthetic (GA) for the treatment of primary acquired nasolacrimal duct obstruction (PANDO). Endoscopic DCR has been constantly refined, with recent studies showing success rates similar to the external method. Potential advantages of endonasal DCR, in addition to scar avoidance, include a possible increase in local anaesthetic (LA) day case procedures.
The aim of this survey is to identify the current DCR surgical practice in the UK regarding commonest surgical approach, preferred mode of anaesthesia and day case rate.

An online questionnaire was sent to 120 lacrimal surgeons in the UK listed on the British Oculoplastic Surgery Society (BOPSS) website.

62 questionnaires were returned (51.6%). Over 70% performed the majority of primary DCR surgery via external approach, with 50% almost exclusively undertaking external DCR’s. Approximately 15% most commonly used LA for external DCR’s, whereas only 6% avoided using GA for the majority of endonasal DCR’s. For external DCR cases, only 4 percent of surgeons routinely planned an inpatient stay, compared to 2% for patients having the endonasal DCR’s.

This survey shows that UK surgeons with a special interest in lacrimal surgery, currently still prefer the external approach, though there is a significant proportion (20%) routinely favouring primary endonasal DCR. The vast majority of external and endonasal DCR procedures are still performed under GA, but interestingly LA use is much commoner for external DCR. Overall there has been a switch to predominantly day case DCR surgery with the proportion of surgeons routinely requiring inpatient stays being low for both groups.