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Dacryocystorhinostomy (DCR)

Overview

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Dacryocystorhinostomy (DCR) is a surgical procedure performed to relieve obstruction of the nasolacrimal duct, which drains tears from the eye into the nose. This condition often leads to epiphora (excessive tearing) and recurrent infections.

DCR creates a new pathway for tear drainage by connecting the lacrimal sac directly to the nasal cavity.

Dacryocystorhinostomy (DCR)
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Rahul Bijarniya
Dr. Rahul Bijarniya
Consultant
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Smita Gupta
Dr. Smita Gupta
Senior Consultant
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Sameer Sethi
Dr. Sameer Sethi
Senior Consultant
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Suven Kalra
Dr. Suven Kalra
Consultant
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How is Dacryocystorhinostomy (DCR) done?

  • Medical History Review: A thorough review of the patient's medical history, including any previous eye or nasal surgeries, allergies, and medications.
  • Physical Examination: An examination of the eyes and nasal passages to assess the severity of the obstruction.
  • Imaging Studies: Imaging, such as a CT scan, may be performed to visualize the anatomy and identify any structural issues.
  • Preoperative Instructions: Patients may be instructed to avoid certain medications (e.g., blood thinners) and to fast prior to surgery.
  • Anesthesia Consultation: Evaluation by an anesthesiologist, particularly if general anesthesia is required.

  • Anesthesia: The procedure can be performed under local or general anesthesia.
  • Access to the Lacrimal Sac: The surgeon makes an incision either on the side of the nose (external approach) or through the nasal cavity (endoscopic approach).
  • Creation of the Fistula: The lacrimal sac is accessed, and a new opening is created to connect it to the nasal cavity, allowing tears to drain properly.
  • Insertion of Stents: Sometimes, silicone stents are placed in the newly formed passage to keep it open during healing.
  • Closure: The incision is closed, and the area is cleaned to prevent infection.

  • Infection: Risk of postoperative infection at the incision site or in the sinus.
  • Scarring: Potential for scarring, which could lead to a recurrence of obstruction.
  • Persistent Symptoms: In some cases, the obstruction may not be fully resolved, leading to ongoing symptoms.
  • Hemorrhage: Bleeding during or after the procedure.
  • Nasal Complications: Issues such as nasal congestion, pain, or change in sensation in the area.
Benefits
  • Relief from Symptoms: Significant reduction in excessive tearing and associated discomfort.
  • Improved Quality of Life: Patients often experience an improved quality of life with fewer infections and clearer vision.
  • Long-term Solution: For many patients, DCR offers a lasting solution to tear drainage issues.

Infrastructure Facilities

  • Surgical Suite: Equipped with necessary surgical instruments, anesthesia machines, and monitoring equipment.
  • Recovery Room: Postoperative care facilities to monitor patients as they wake from anesthesia.
  • Diagnostic Imaging: Access to imaging facilities for preoperative planning and assessment.
  • Nursing Support: Trained nursing staff for preoperative and postoperative care.

FAQs

The procedure typically takes about 30 to 90 minutes, depending on the approach and complexity.

Most patients can return to normal activities within a week, but full recovery may take several weeks.

In some cases, conservative treatments like warm compresses or medication may help, but they are often not a long-term solution.

A small dressing may be applied over the incision, and some patients may have nasal packing, which is usually removed shortly after surgery.

While many patients experience success, there is a risk of failure, which may require additional procedures.

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