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Nasolacrimal Duct Repair

Great Surgical Care at Marina del Rey Hospital

Why Choose Cedars-Sinai Marina del Rey Hospital for Nasolacrimal Duct Repair?

The impairment of vision can do serious harm to your way of living and the medical technology available at Cedars-Sinai Marina del Rey Hospital will help our experienced surgeons in providing you with the best treatment available for your condition.

The nasolacrimal duct repair (DCR for short) performed at our LA facility is one of the safest procedures guaranteeing a high success rate and a quick recovery so you can get back to the activities and the life you enjoy most.

A blockage of the normal flow of tears through the nasolacrimal duct may cause excessive tearing, blurred vision, and the duct may become swollen, filled with liquid and even infected.  

The surgical procedure that is usually required to reconstruct the tear duct is called DCR (dacryocystorhinostomy). The operation can be performed through the nose (endonasal DCR) or externally, through a small incision in the side of the nose.

Both external and endonasal DCR are same-day surgical procedures with similarly high success rates. They are performed under local or general anesthesia and last 1 to 1 1/2 hours on average. In order to perform the DCR, the following steps are undertaken:

  • You will check into the hospital and change into a medical gown
  • You will be brought to a surgical suite and placed under general or local anesthesia
  • An approximately 1 cm incision will be made on the side of the nose in the case of external DCR
  • After the small lacrimal bone is removed, the upper part of the tear sac will be connected to the lining of the nose in order to form a new tear drain between the eye and the nose
  • In order to protect the lining of the new tear passage and prevent scarring, the surgeon may temporarily pass a piece of silicone plastic tubing through the tear ducts (to be removed 4 to 6 weeks postoperatively)
  • The small incision will be closed and the sutures will be removed in about a week
  • In the case of endoscopic DCR, which is a minimally invasive, scarless procedure,  endoscopic surgery instruments are used to reconstruct the nasolacrimal duct through the nasal cavity

DCR is a safe and effective surgical procedure with excellent success rates (up to 95%) and minimal scarring. In order to establish if DCR is the right procedure for you, a number of tests will be performed by an eye doctor. Besides the assessment of your symptoms, checking your vision and measuring eye pressure, more complex tests may be required: a telescopic examination of your nose, eye imaging, syringe or tear drainage tests. The correct treatment will mainly depend on the cause of the blockage:

  • Dilation, probing and irrigation is a technique usually used in the case of a congenital blocked tear duct
  • Balloon catheter dilation is performed when the blockage is caused by inflammation or scarring
  • Simple observation is usually the first step to be taken when the blockage is caused by facial injury, as the heeling process may also help with the unblocking of the tear ducts
  • If a tumor blocks the tear duct, the main concern will be the removal of the tumor
  • Surgery (DCR) is the right solution for older children and adults with primary or secondary acquired nasolacrimal duct obstruction and/or with previous infection of the tear duct (dacryocystitis). It is also appropriate for patients with congenital nasolacrimal duct obstruction, whose other treatments have failed

The risks involved in DCR are minor and severe complications are unlikely. Some of the risks, common to all surgical procedures, are related to anesthesia. Other potential risks are:

  • local swelling and bruising
  • excessive nose bleeding
  • infection at the site of the incision
  • scarring of the drainage tubes
  • displacement of the tube
  • incomplete improvement of the blockage

Have you experienced excessive tearing or repeated eye infections, painful eye inflammation or discharge? Have you had your nasolacrimal duct blockage unsuccessfully treated using non-invasive procedures? You may be a good candidate for DCR surgery. Call us at 310.823.8911 to find out more and schedule a consultation today!

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