A dacryocystorhinostomy (DCR) is a type of surgery. It’s done to create a new tear duct between your eyes and nose. You may need this surgery if your own tear duct has become blocked.
What to tell your healthcare provider
Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. And tell your healthcare provider if you:
Have had any recent changes in your health, such as an infection or fever
Are sensitive or allergic to any medicines, latex, tape, and anesthesia (local and general)
Are pregnant or think you may be pregnant
Tests before your surgery
Before your surgery, you may need imaging tests. These may include:
CT scan of your nasal passages
MRI scan of your nasal passages
Getting ready for your surgery
Talk with your healthcare provider about how to prepare for your surgery. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.
Also, make sure to:
Ask a family member or friend to take you home from the hospital. You can't drive yourself.
Follow any directions you are given for not eating or drinking before your surgery.
Follow all other instructions from your healthcare provider.
You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully. Ask questions if something is not clear.
On the day of your surgery
Your surgery will most likely be done by a doctor trained in ophthalmic plastic surgery. He or she will work with a team of specialized nurses. The surgery can be done in several ways. Ask your doctor about the details of your surgery. In general, you can expect the following:
You may have general anesthesia. This will cause you to sleep through the surgery and not feel pain. Or you may be awake during the surgery. You may get a medicine to help you relax.
Small sponges or other materials will be put inside your nose. These have anesthetic on them to prevent pain during the surgery. They may also have medicine to help you bleed less during the surgery. You may also have a shot to numb the area.
The doctor may make a small cut (incision) below or near your eyelid. This is done under your eye and next to your nose. Or the doctor may enter through your nose instead of using an incision below or near your eyelid.
The doctor will make a small hole in the bone in this area. This makes a new opening between the lacrimal sac and your nose. In some cases, a small tube (stent) may be put into the opening. This is to help keep it open.
The doctor may close the incision with stitches (sutures).
After your surgery
Ask your healthcare provider what to expect after your surgery. Your nose may be refilled with packing material to reduce your chance of bleeding. You may be able to go home the same day. Plan to have someone go home with you after the procedure.
Recovering at home
Follow your healthcare provider’s instructions about caring for your eye, nose, and incision. The area may be a little sore after the surgery. You may be able to take over-the-counter pain medicine. It is normal to have some bruising around the area.
You may need to take antibiotics. This is to help prevent infection. Your healthcare provider may also give you instructions for rinsing your nose. You may also need to take other medicines. These may include steroids and nasal decongestants.
Ask your healthcare provider if you should avoid certain activities while you recover.
You will need follow-up care to see how well the surgery worked. You may have an appointment the day after the surgery. If you have a stent, you may need to have it removed a few months later. Make sure to keep all of your follow-up appointments.
When to call your healthcare provider
Call your healthcare provider if you have any of the following:
Fever of 100.4°F (38°C) or higher, or as directed by your provider
Pain or swelling that gets worse
June 21, 2018
Ali MJ, Naik MN, Honavar SG. External dacryocystorhinostomy: tips and tricks. Oman J Opthalmol. 2012;5(3):191-5., Karim R, Ghabrial R, Lynch TF, Tang B. A comparison of external and endoscopic endonasal dacryocystorhinostomy of acquired nasolacrimal duct obstruction. Clin Ophthalmol. 2011;5:979-89., Kashkouli MB, Sadeghipour A, Kaghazhanai R, et al. Pathogenesis of primary acquired nasolacrimal duct obstruction. Orbit. 2010;29(1):11-15.
Bogus, William J., OD, FAAO,Haupert, Christopher L., MD,Image reviewed by StayWell medical illustration team.,MMI board-certified, academically affiliated clinician,Turley, Ray, BSN, MSN