Bilateral, Simultaneous Common Canalicular Obstruction Occurring 10 Years after Endoscopic Dacryocystorhinostomy: A Case Report.

Introduction: Dacryocystorhinostomy (DCR) is the gold standard treatment for nasolacrimal duct obstruction, with high long-term success rates. Failure most commonly occurs early, while late complications are rare and less well characterised. Common canalicular obstruction is an increasingly recognised cause of delayed failure. Case Presentation: This report describes a 71-year-old female who presented 10 years after sequential bilateral endoscopic DCR with spontaneous, simultaneous recurrence of bilateral epiphora. Endoscopic examination demonstrated patent nasal ostia with bilateral common canalicular obstruction. The patient had no identifiable risk factors for canalicular disease. She underwent revision bilateral endoscopic DCR with membranotomy and silicone intubation, with intraoperative findings confirming distal membranous obstruction. Complete symptom resolution was achieved at follow-up. Conclusion: This case highlights that late DCR failure may occur even after a decade and may be attributable to common canalicular obstruction. The unusual bilateral and simultaneous presentation raises the possibility of underlying inflammatory mechanisms. Clinicians should maintain long-term awareness of this rare complication.