DCR

Dacryocystorhinostomy Surgery in Hyderabad

Every eye has a fine drain pipe leading from the eye to the nose, through which tears reach the throat. This pipe is called the nasolacrimal duct. A child may be born with a blockage in the nasolacrimal duct. This type of condition is called congenital dacryostenosis. Water mixed with some sticky substance may come out of the eye which might make it look like the child is crying all the time. This condition is usually observed from a few weeks after birth. Blockage of the tear drainage system may often lead to troublesome watering and discharge all the time as well as an acute infection of the lacrimal sac not only in children but also in people of all ages. This type of blockage can be partial or complete at any site from the lacrimal puncta to the nasolacrimal duct. 

A Dacryocystorhinostomy Surgery in Hyderabad can be performed as a treatment method by which a new tear duct is created from the eye to the nose so that tears can drain out through that passage. CARE Hospitals offer comprehensive diagnosis, as well as medical, and surgical treatments for a wide spectrum of signs and symptoms suffered by a patient. With state-of-the-art infrastructure equipped with modern technology, our world-renowned multidisciplinary team of medical and surgical specialists take special care to deliver the best possible results using minimally invasive treatment procedures while following international standards and protocols. Get treated for congenital dacryostenosis following proper diagnosis using the latest technology. 

Symptoms of a blocked tear duct

If the tear duct has been blocked due to anatomical anomalies (usually congenital), it may cause many troubles in the patient. Some of the symptoms include:

• Continual tearing up of the eyes

• Sticky discharge from the eyes

• Pain at the tear duct or the surrounding areas.

Causes of a blocked tear duct

In most cases, the reason for a blocked duct is not clearly known. However, there may be some cases where blockage of ducts can be caused by:

• Congenital structural anomalies,

• Chronic nasal and sinus inflammation,

• Obstruction from a tumour,

• Trauma to the nose,

• Conjunctivitis.

An ophthalmologist may perform some tests on the tear ducts to determine the presence, type and location of the obstruction.

What is dacryocystorhinostomy (DCR)?

A dacryocystorhinostomy (DCR) is a surgical procedure used to create a new path for tears to drain due to blockage in the original tear ducts owing to structural anomalies. The procedure can be performed externally through a minimal incision on the skin, or endoscopically through the nasal duct which leaves no scar on the skin. Both methods are equally effective and successful.

Why do I need DCR?

The dacryocystorhinostomy surgery in Hyderabad surgery is done to reduce the symptoms associated with a blocked tear duct. These symptoms include excessive tearing up of the eye or crusting around the eye. If the tear ducts are affected, the following symptoms  may be experienced:

• Swelling and tenderness around the eyes,

• Eye irritation,

• Mucous discharge.

Not everyone who has blocked tear ducts may need surgery, the surgery is more commonly done on adults than in children. At first, a less invasive procedure may be recommended which can include warm compresses, massages, and antibiotics for any infection. However, if the symptoms are severe, a DCR surgery may be recommended. Sometimes, an external surgery may be performed, or to avoid an external scar, an internal surgery using a rigid tube which is to be inserted into the nasal cavity to perform the surgery.

Preparation for Dacryocystorhinostomy

Preparing for a dacryocystorhinostomy (DCR) is crucial for ensuring a successful surgery and recovery. Here’s what you need to know:

• Consultation with the Surgeon
  • Discussion: You will meet with your surgeon to discuss your symptoms, the reason for the surgery, and what to expect.
  • Assessment: The surgeon will evaluate your tear ducts by administering a saline solution to identify any blockages and determine their size.
• Pre-operative Examination
  • Health Check: A thorough physical examination will be conducted to assess your overall health and suitability for the procedure.
  • Medical History: Inform your surgeon about your complete medical history, including any previous surgeries or existing health conditions.
• Medication Review
  • Current Medications: Provide a list of all medications, supplements, and vitamins you are taking.
  • Instructions: Your surgeon will advise you on which medications to continue or discontinue before surgery, particularly blood thinners or anti-inflammatory drugs.
• Eating and Drinking Instructions
  • Fasting: You will usually be instructed not to eat or drink anything after midnight prior to your surgery. This helps minimize risks during the procedure.
• Pre-operative Testing
  • Additional Tests: Depending on your health status, your surgeon may request blood tests or other diagnostic evaluations to ensure you are fit for surgery.
• Follow-Up Appointment
  • Recovery Plan: Schedule a follow-up visit to monitor your recovery and address any concerns that may arise post-surgery.

Dacryocystorhinostomy Surgery

During an external DCR surgery, an opening from the lacrimal sac is created to the nasal cavity. A small incision is made on the skin in the area around the eye near the nose to make a passage for tear drainage, in the bone beneath. 

In an endoscopic DCR surgery, a team of sinus and eye surgeons work together to bypass a tear duct by creating a new opening directly from the lacrimal sac to the nasal cavity. While going through the nasal passage using endoscopic vision, the sinus surgeon creates an opening in the bone beneath the lacrimal sac. 

Post-surgery, in both types of surgery, a small tube may be left in place to help keep the new duck open and working.

What happens after DCR surgery?

There is a chance of soreness after the procedure, but over-the-counter medications may help relieve such symptoms. It is also normal to have some bruising post-external surgery. The nose may be filled with some stuffing material to prevent chances of bleeding. In most cases post-surgery, patients may be discharged on the same day of surgery. 

Instructions about nasal cavity rinsing and other medications such as steroids and nasal decongestants may be provided by the doctor. Close follow-up care with the care provider team may be required to check post-surgery recovery and progress. 

How do I get prepared for DCR?

Here are the steps to prepare for a Dacryocystorhinostomy (DCR) surgery:

• Medical Evaluation: Complete any required medical tests and evaluations before surgery.
• Medications: Discuss with your doctor about medications you're taking, and follow their advice on which to stop or adjust.
• Physical Health: Maintain a healthy diet and lifestyle to optimize recovery.
• Logistics: Arrange transportation for the day of surgery and plan for post-operative care at home.
• Pre-Op Instructions: Follow your surgeon's specific guidelines on fasting, hygiene, and preparation.

Complications during the DCR surgery

Some potential complications include:

• Bleeding: Excessive bleeding during or after surgery can occur, which may require intervention to control.
• Infection: There is a risk of developing a surgical site infection, which can manifest as redness, swelling, pain, or discharge.
• Anesthesia Risks: Adverse reactions to anesthesia can occur, such as respiratory issues or allergic reactions.
• Scarring: Scar tissue formation at the surgical site can occasionally affect tear drainage.
• Incomplete Resolution: In some cases, the surgery may not completely resolve the blockage or may require revision surgery.
• Damage to Surrounding Structures: There is a small risk of injury to nearby structures, such as the nasal septum or surrounding tissues.
• Recurrence: Rarely, the blockage can recur over time, requiring further evaluation and treatment.

Post-op of DCR surgery

Here are some guidelines for post-operative care:

• Pain Management: Your surgeon may prescribe pain medication to manage discomfort. Follow their instructions for taking medications as directed.
• Swelling and Bruising: Swelling and bruising around the surgical site and eye area are common. Applying cold compresses gently can help reduce swelling.
• Activity: Rest as much as possible in the first few days after surgery. Avoid strenuous activities and lifting heavy objects.
• Nasal Care: Your surgeon may recommend nasal saline rinses to keep the nasal passages clean and moist. Follow their instructions on how to perform these rinses.
• Eye Care: Your eye may be sensitive or watery post-operatively. Use prescribed eye drops or ointments as directed to keep the eye lubricated and reduce irritation.
• Follow-up Appointments: Attend all scheduled follow-up appointments with your surgeon. They will monitor your healing progress and remove any nasal packing or sutures if necessary.
• Diet: Follow any dietary restrictions recommended by your surgeon, especially related to drinking fluids and eating soft foods initially.
• Avoiding Irritants: Avoid activities that could increase pressure in the nose, such as blowing the nose forcefully or sneezing with the mouth closed, as these actions could disrupt the healing process.
• Symptom Monitoring: Watch for signs of infection, such as increasing pain, redness, swelling, or fever. Contact your surgeon if you experience any concerning symptoms.

What is the success rate of DCR surgery?

The success rate of the dacryocystorhinostomy surgery in Hyderabad surgery mostly depends on the underlying cause of watering. In general, the possibility of curing troublesome discharge and stickiness is near about 95 percent.