What is Lacrimal Surgery?
Our tear glands produce tears constantly to keep our eyes moist, clean, and nourished. The tears will eventually drain into the nose cavity through a system of ducts or pipes.
Any blockage in the drainage ducts can prevent the tears from draining into the nose, thus leading to watery eyes.
A narrowed tear drainage duct may lead to an accumulation of mucus or pus causing serious infection of the tear sac. An infection of the tear sac is called dacryocystitis.
Lacrimal surgery is also known as Dacryocystorhinostomy (DCR), a surgery to create a bypass from the inner corner of the eye directly into the nasal passage.
A new pathway is created between the lacrimal sac and the adjacent nasal space by removing a small piece of bone between them and thus bypassing the blocked nasolacrimal duct.
In some patients, a small silicone tube is placed to keep the bypass channel open which can be easily removed in the clinic.
Types of Lacrimal/DCR Surgery:
External Lacrimal/DCR
A 1 cm incision is made on the skin over the tear sac beside the affected nose. A small hole is made on the lacrimal bone to create a new passageway connecting the lacrimal sac to the nose. In some patients, a silicone tube (stent) is inserted into the tear duct to keep the passage open until its removal 6 to 8 weeks later. The incision is closed with stitches which can be removed after one week.
Endoscopic Lacrimal/DCR
This is a minimally invasive method of performing the surgery using fibre optic rigid endoscopes and powered diamond coated instruments. This method of surgery does not leave any visible facial scar on the patient. In addition, an endonasal surgery has a faster recovery time, with less blood loss, and a success rate comparable to an external surgery.
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Consultant Ophthalmologist, Oculoplastic & Lacrimal Surgeon
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