What is Dacryocystorhinostomy (DCR)?
Dacryocystorhinostomy (DCR) is a surgical procedure designed to restore the normal flow of tears from the eyes into the nose, alleviating excessive tearing (epiphora). When the tear drainage system (also called the lacrimal system) is blocked, tears cannot drain properly, leading to tear buildup, infection, and discomfort. DCR creates a new drainage pathway to bypass the obstruction, allowing tears to flow normally again.
Why would someone need DCR surgery?
DCR is typically recommended for patients with:
Chronic tear duct blockage: This may be due to congenital issues, infection, or structural damage.
Recurrent dacryocystitis: Frequent infections of the lacrimal sac, often due to tear stagnation.
Nasal or facial trauma: Injuries or previous surgeries that block the tear ducts.
Tumors: Tumors obstructing the tear drainage system.
Other causes: Conditions like dacryolithiasis (tear duct stones) and canaliculitis (inflammation of the tear ducts).
What symptoms suggest a blocked tear duct?
- Excessive tearing from one or both eyes
- Swelling, redness, or pain in the inner corner of the eye
- Discharge of pus from the eyes
- Crusting around the eyes, especially after sleeping
- Blurred vision due to tear accumulation
What types of DCR procedures are there?
There are two main approaches to DCR surgery:
External DCR: In this method, the surgeon makes a small incision on the side of the nose near the tear sac. This approach is commonly performed by ophthalmologists and has a high success rate.
Endoscopic DCR: This method involves using a tiny camera (endoscope) inserted through the nose to access the tear duct. This procedure leaves no visible scar and is less invasive but requires specialized training and equipment.
What are the advantages of endoscopic DCR?
- No visible scars
- A one-stage procedure
- Less bleeding and shorter operative time
- Minimal disruption of surrounding structures
What should I expect after DCR surgery?
Pain and swelling: Some discomfort, bruising, and swelling around the eye and nose are common after surgery. Pain can be managed with medications.
Watery eyes: It is normal to experience watery eyes for a few weeks as the inflammation subsides.
Nasal packing: For endoscopic DCR, nasal packing may be used to control bleeding and will need to stay in place for 24-48 hours (about 2 days).
Follow-up care: You will need to use prescribed eye drops and saline rinses to promote healing and prevent infection. Follow-up appointments are essential to monitor your progress and remove any stents.
How long does it take to recover from DCR?
Recovery typically takes about two weeks. During this period, patients are advised to:
- Avoid vigorous activities, swimming, and heavy lifting
- Keep the head elevated to reduce swelling
- Stay indoors to avoid exposure to dust or pollutants
- Avoid blowing the nose or using eye makeup
Most patients can return to normal activities, including work and exercise, within two weeks.
Dacryocystorhinostomy (DCR) is a highly effective surgical solution for blocked tear ducts. By restoring normal tear drainage, DCR improves both the function and comfort of the eyes, allowing patients to enjoy a better quality of life.
