What is a dacryocystorhinostomy?

A Tear Duct known as a dacryocystorhinostomy (DCR) is a surgery that creates a new path for tears to drain between your eyes and your nose. You may need this surgery if your tear duct has become blocked. The procedure can be performed externally through an incision in the skin, or endoscopically through the nose without leaving a skin incision. Both methods are equally successful .

what are the Symptoms of a Blocked Tear Duct?

There are Symptoms to indicate that there is an obstruction in the tear duct. these Symptoms include:

• Tearing
• Discharge from the eye
• Pain at the tear duct or surrounding area
• The vision becomes blurred due to the excess of tears, which may lead to amblyopia.
• The white part of the eye becomes red.
• Excessive mucus on the surface of the eye.

How is tear duct surgery performed?

• DCR Through the Skin (External Procedure) During an external DCR, your oculoplastic surgeon creates an opening from the lacrimal sac to your nasal cavity. The surgeon makes a small incision in the skin, in the area under your eye and next to your nose. Through this incision, your surgeon creates a small opening in the bone beneath. This opening then connects your lacrimal sac and your nasal cavity. The surgeon leaves a small tube there to help keep the new tear duct open
• Endoscopic DCR (Minimally Invasive) During an endoscopic DCR, the sinus surgeon works together with the eye surgeon to bypass the tear duct by creating a new opening directly from the lacrimal sac to your nasal cavity. Going through the nasal passage under endoscopic vision, the sinus surgeon creates an opening in the bone that overlies the lacrimal sac. A connection is then created between the lacrimal sac and your nasal cavity. The ophthalmic plastic surgeon usually places a small tube there to help keep the new tear duct open.

What Happens Before Tear Duct Blockage Surgery?

The ophthalmologist will do an eye exam to make sure your child has a blocked tear duct and not another eye problem that could cause similar symptoms. The doctor also might do a simple and painless dye test. Putting a special dye in the eye lets the doctor measure the amount of tears it makes and see if they're draining properly.

What Happens During Tear Duct Blockage Surgery?

Newborns sometimes can have a blocked duct opened in the ophthalmologist's office without anesthesia. Older infants and children need to go to a hospital or surgery center where they will get anesthesia (medicine to help them sleep and not feel pain).
An ophthalmologist can do different types of surgical procedures (sometimes in combination) to open a blockage:

• Probing using a thin metal instrument: The ophthalmologist gently passes a thin metal instrument (probe) through the tear duct to open the blockage. Then they flush the duct with sterile water to make sure the pathway is clear. This is the procedure most often used for blocked tear ducts.
• Silicone tube intubation: The ophthalmologist places silicone tubes in the tear ducts to stretch the ducts. The tubes stay in place for 3–6 months, then are removed either in the office or during another short procedure.
• Balloon catheter dilation: The ophthalmologist puts a balloon into the tear duct and inflates it with a sterile solution. This expands the tear duct.

How Long Does Tear Duct Blockage Surgery Take?

The procedure takes about 10–20 minutes, depending on which type is done.

Lacrimal duct surgery complications and risks:

Even though this surgery is a simple procedure, it is accompanied by some complications such as:

• Bleeding
• Infections
• Permanent scars if the external technique is employed
• The displacement of the stent if one is placed during the surgery