External DCR (dacryocystorhinostomy) Surgery
A common cause of tearing is from scarring or narrowing in the tear drainage system. This may be due to injury, infection or a stone (calculus) within the drainage system, but often we cannot be certain of the cause of the obstruction. As the tears are being constantly produced by the tear glands, if the tear drainage system is not working well then tears will build up and cause a watery eye or they can overflow over the eyelids onto the cheeks resulting in “epiphora”.
If there is a narrowing or blockage of the tear outflow tract then surgery can be performed to create a functioning tear drainage system. This surgery is called a Dacryocystorhinostomy or DCR.
Dacryocystorhinostomy (DCR) was initially described in 1829 as an external or skin based approach. An incision is made in the skin on the side wall of the nose to gain access to the tear sac and the nasal cavity. This procedure is commonly performed as a day surgical procedure under local anaesthesia with sedation.
What are the symptoms of a blocked tear duct?
Poor tear drainage can lead to recurrent infections, either in the form of conjunctivitis, or even severe infection and abscess formation within the tear duct and sac.
More common symptoms include, blurring of vision, inability to keep glasses from fogging up and mucus discharge.
When should tear duct obstruction be treated?
What does the treatment involve?
How will I look immediately after surgery?
What is the recovery time?
What are the risks?
How long do the results of the surgery last?
The success rate for endoscopic and external DCR is approximately 95%, however tear drainage is a very complex physiological process and tearing may be the result of a number of separate issues. Therefore careful patient selection is essential.
Patients have follow-up for three months to ensure that the new tear pathway matures well. After this period it is very unlikely for the tearing to recur.
Is there anyone who shouldn't have this surgery?