Dacryocystorhinostomy (DCR)
Also known as Tear Duct Surgery, Tear Drain Bypass, Blocked Tear Duct Surgery, Endoscopic Dacryocystorhinostomy, External Dacryocystorhinostomy
Bottom Line
Dacryocystorhinostomy is tear duct bypass surgery. It creates a new drain from the tear sac into the nose when the natural duct is blocked.
Dacryocystorhinostomy creates a new pathway for tears to drain into the nose. It is used when the tear duct is blocked and causes constant tearing or infections.
The surgery can be done through a small skin incision or through the nose with an endoscope. A systematic review compared external and endoscopic dacryocystorhinostomy outcomes 1.
Some surgeons place a soft silicone tube during healing. The tube keeps the new passage open while swelling settles.
How It Works
Tears normally drain through small eyelid openings into a sac, then down a duct into the nose.
When the lower duct is blocked, tears back up. Mucus and infection can collect in the tear sac.
This surgery makes a new opening from the sac into the nose. It bypasses the blocked duct.
Who It Helps
The surgery helps people with confirmed blockage of the lower tear duct.
- Constant tearing. Tears run down the cheek even when the eye is not dry.
- Repeated discharge. Mucus can reflux from the tear sac.
- Recurrent infections. A blocked sac can become painful and swollen.
Dry eye, eyelid looseness, or allergy can also cause tearing. Those need different care.
Risks And Follow-Up
Risks include bleeding, infection, scarring, tube irritation, nose symptoms, and the new opening closing.
External surgery can leave a small scar near the nose. Endoscopic surgery avoids a skin incision.
Call the surgeon for fever, heavy bleeding, worsening pain, or spreading redness.
Cost And Insurance
This surgery is often covered when testing shows a blocked tear duct and symptoms are significant.
Costs can include surgeon, facility, anesthesia, nasal endoscopy, tubes, and follow-up visits.
Ask whether an ear, nose, and throat surgeon will also bill for the nasal part.
Common Questions About Dacryocystorhinostomy
Next Steps
- 1Ask for testing to confirm where the tear drainage system is blocked.
- 2Review external and endoscopic options with an oculoplastics specialist.
- 3Treat active infection before elective surgery unless your surgeon directs otherwise.
- 4Ask whether a silicone tube will be used and when it would come out.
- 5Call promptly for fever, spreading redness, heavy bleeding, or worsening pain.
Find specialists for Dacryocystorhinostomy (DCR)
Board-certified ophthalmologists who treat Dacryocystorhinostomy (DCR).
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