Global Research Trends in Endoscopic and External Dacryocystorhinostomy: A Bibliometric Analysis.

Aim: To carry out an exhaustive bibliometric analysis of the existing literature on endoscopic dacryocystorhinostomy (DCR), with a view to comparing this with the trend in external DCR.

Methods: A total of 1,230 publications on endoscopic DCR and 1,036 on external DCR were retrieved from the Web of Science databases and analyzed. Data on publication types, indexing categories, journal and publisher contributions, temporal trends, authorship networks, frequently used keywords, and country-level contributions were evaluated. Co-authorship and keyword co-occurrence networks were visualized to identify collaboration patterns and thematic focuses. Citation metrics, including the top 100 most-cited publications, were also assessed.

Results: Original articles accounted for over 85% of the publications in both endoscopic and external DCR literature. The research is predominantly concentrated in ophthalmology (44.4%) and otorhinolaryngology (32.1%) for endoscopic DCR, with most publications indexed in the Science Citation Index Expanded (77.3%). The number of endoscopic DCR publications peaked in 2020, while external DCR peaked in 2015. Ali Mohammad Javed emerged as the most prolific author with 78 publications, and the co-authorship network revealed strong interdisciplinary collaborations. India led the publication output for both endoscopic (16.9%) and external (15.7%) DCR, followed by the United States and Turkey. Frequently used keywords such as "dacryocystorhinostomy" and "epiphora" highlighted the primary clinical focus.

Conclusion: The bibliometric analysis highlights the increasing trend in publications over the last decade, indicating an escalating interest in minimally invasive methods, with endoscopic DCR being a prominent approach for the management of nasolacrimal duct obstruction. Key contributors, impactful journals, and strong collaborations drive innovation in the field. However, research gaps remain in patient-reported metrics, and contributions from underrepresented regions. Addressing these areas through international and multidisciplinary efforts will advance the field further.