Dacryocystorhinostomy (DCR) also known as 'watering eye surgery' is a surgical procedure that makes a new passage for the tears to pass from the eye to the nose. It aims to stop fluid and mucus blockage within the lacrimal sac (tear sac), and to increase tear drainage for the relief of epiphora (watering eyes). This procedure is also known as lachrymal surgery or tear duct bypass surgery.
There are two ways of performing this surgery:
- External DCR – done through a small incision on the side of the nose
- Endoscopic DCR – done from inside the nostril, so no scars are visible.
Most external DCR operations are carried out under local anaesthetic as a day procedure. During an external DCR, your surgeon will make a small cut on the side of the nose to access the tear sac. A piece of bone between the tear sac and nose will be removed to reach the inside of the nose.
The tear sac is opened and stitched to the lining of the nose so a direct passage is formed between the sac and the nose. A soft silicone ‘tube’ or thread may be put into the tear passage to keep it open during healing. This tube is removed in clinic about 6 -12 weeks after the operation. External DCR takes about one hour to 90 minutes.
Most endoscopic DCRs are performed with a general anaesthetic. In this operation, your eye surgeon will access the inside of the nose by using a small telescopic instrument called an endoscope. This will allow the surgeon to see inside the nostril and make a small opening between the tear sac and the lining of the nose but without using stitches.
The opening is smaller than with an external DCR and the operation is usually quicker. There is no cut in the skin for this endoscopic DCR operation. So, there will be no scar with this operation. Your surgeon will place silicone tubing into the tube passage to keep this open.
If you have local anaesthetic, you should be able to leave the hospital a few hours after the procedure. If you have general anaesthetic, you will usually stay for one night to recover before returning to your regular activities.
After both types of DCR procedures, you will receive eye drops to use for a few days, and detailed aftercare instructions on how to improve your recovery. You will need to return to the clinic several times after the operation so your doctor can monitor and manage your recovery.
Like any surgery, there are some risks associated with this procedure.
At Circle Health, your specialist consultant will discuss the benefits and risks of these operations in a private consultation to answer your questions or concerns, and help you decide upon the most suitable treatment for you.