Dacrocystorhinostomy (DCR)

About your treatment

A DCR is an operation to relieve a blocked tear duct which will improve the drainage of your tears and stop your eye watering. If left untreated, the tear duct may become infected causing pain and discomfort.


Before your operation

You would have been seen by both an Ophthalmologist (Eye Surgeon) and an Ear, Nose and Throat (ENT) surgeon to explain the operation to you.

If you have any medical conditions you must inform the surgeon. Inform the surgeon if you are taking any medications that may affect blood clotting such as Aspirin, Warfarin and Clopidogrel (Plavix).

Stop all garlic, ginger and pycnogenol tablets or any other natural remedies containing Garlic at least one week prior to surgery as this increases the risk of bleeding during and immediately after surgery.

The Surgery

This can be performed under general or local anaesthesia. You will be advised about this by your surgeon.

The surgery is performed through the nose via an endoscope, (a small tube with a fibre optic light). There are no external scars.

Once the tear duct has been reopened, a plastic tube or stent is placed through the tear ducts into the nose and is usually left in place for six to eight weeks. This will be removed in the outpatient department.

The operation usually takes between 20 to 30 minutes

After your operation

Usually no dressings are required, however if bleeding has been a problem during surgery you will wake up with nasal packs in place. These are removed by the nurse or doctor after a few hours. In severe cases they may need to be left in place overnight.

After leaving hospital

Your nose will feel very blocked for the first 2 weeks. During this period there will be minimal bleeding which will soon turn to clotted blood. You will also experience crusts in the nose which will slowly clear over the following 2 -3 weeks.

You will be given analgesia (pain killers) to take home along with instructions on nasal douching which is a very effective method for clearing the crusts and clots in your nose.

If your eyelids become sticky you may bathe them with cooled boiled water and soft gauze swabs. Use each piece of gauze once and then throw it away.

Try to avoid wiping your eye as you may dislodge the tube. If this happens you need to contact the ENT surgeon.

We recommend 4 days off work.

Length of stay

Depending on what time the surgery takes place you may either go home on the same day (Day Surgery) or stay in hospital overnight.

Complications

1. Bleeding
The nose has a very large blood supply. Troublesome bleeding is therefore the commonest complication of any nose or sinus surgery. Should this occur please contact the hospital for advice or go to your nearest A&E department.
2. Bruising
The wall between the orbit (eye socket) and the sinus is very thin. Blood from the sinus can ooze into the orbit causing a black eye. This is rare and should settle in 10-14 days. During this period avoid blowing your nose
3. Infection
If you experience increasing pain or green discharge from your nose after surgery, you may have an infection and should take a course of antibiotics.
4. Loss of Vision
This is extremely rare and should only be an issue in patients with very severe sinus disease.
5. CSF leak
This is a very rare complication. If you experience clear fluid flowing from your nose especially when bending forwards or down the back of your throat when laying back you should inform your surgeon, as there maybe be a leak of brain fluid.
6. Smell
Sense of smell may sometimes be affected.