Endoscopic Dacrocystorhinostomy (DCR) (Surgery for a watery eye)
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Tears normally drain via openings in the upper and lower eyelids into the tear sac and from there into the nose – see Diagram 1.
A blockage of the tear drainage system may cause a watery eye and/or recurrent infections in the tear sac – see Diagram 2.
Surgery to correct the blockage (DCR) involves bypassing the blockage and creating a new opening from the tear sac into the nose – see Diagram 3.
About the Operation
The operation is usually performed under General Anaesthetic (asleep) and takes 45 – 60 minutes. The surgeon will use an endoscope (small, fine telescope) to operate inside the nose to create a new opening in the tear sac. There will be no cuts in the skin. Once the opening has been created, a fine silicone tube may be passed through the tear ducts and secured within the nose. The silicone tube will help keep the new opening in the tear sac open, but is not always required. If present, the silicone tubing will be removed in outpatients in approximately 3 months (this procedure is very quick and requires no anaesthetic).
Sometimes it is necessary for the surgeon to perform a Septoplasty in addition to the DCR. This additional procedure involves straightening the cartilage that separates the two sides of the nose to allow for additional access to the tear sac. There should be no change in the appearance of your nose after the operation.
How long do I Stay in Hospital?
Usually you will be ready to leave the hospital later on the same day as your operation. If you need to stay overnight, a bed will be allocated to you.
After the Operation
It is usual to experience a sensation of blockage inside your nose after the operation (similar to a cold). This will start to reduce in 1 to 2 weeks. Some discharge from the nose is also expected. This may initially be bloodstained but will become clear over the first 1 to 2 days. Although uncommon, there may be some swelling / bruising to the area between your nose and eye – this will settle quickly. Pain is not severe with this procedure and any discomfort should be easily controlled with simple painkillers. Any discomfort should disappear within a few days.
If silicone tubing has been inserted, you may notice this in the corner of your eye. Initially you may be aware of the tubing, however it should not be uncomfortable and within 24 hours you will not feel it. Take care not to touch or wipe your eye as any unexpected movement of the tubing may affect the success of the operation.
Drops – You will need to use eye drops in the operated eye for one month, and nose drops for 6 weeks after your operation. Do not blow / pick your nose for 6 weeks after your operation.
Cleaning – You should start douching (flushing out) your nose on the second day after your operation and continue for 4 weeks. You will receive instructions and equipment to perform this procedure at your pre-assessment appointment and / or on the ward.
Exercise – You should rest for the first few days after surgery then slowly introduce normal activities. You must avoid strenuous exercise / heavy lifting etc for 2 weeks.
Work – You should arrange to have 7 – 10 days off work.
If you have any problems after your surgery, then please contact the ward on 01908 995470.
You will receive an outpatient appointment to be seen in Mr. Draper’s Clinic 2 weeks after your operation.