External Dacryo-Cysto-Rhinostomy (DCR) by Dr Vidushi Sharma Pandey SuVi Eye Inst. Kota India

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• published: 17 Jun 2015
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External Dacryo-Cysto-Rhinostomy (DCR)(known as NASSOR in Hindi) operations are done to relieve a watery, sticky eye caused by a blockage between the tear sac at the corner of the eye and the tear duct into the nose. The aim of surgery is to make a new passage from the tear sac into the nose. This bypasses the blockage and allows the tears to drain normally again. DCR surgery is worth undertaking if the watering is bad enough to interfere with patient's daily life. It is also recommended if patient has had an attack of acute dacryocystitis (infection in the tear sac) as a result of a blocked tear duct; otherwise patient may have repeated attacks of a red, painful swelling at the corner of the eye. The surgery can be performed in two ways: · Externally -- through the skin · Endoscopically -- from within the nostril. External DCR: A small cut (1-2 cm) is made on the side of the nose, approximately where a pair of glasses rests. A piece of bone between the tear sac and the nose is removed to make a new channel for the tears. Some surgeons use (Not shown in this video) a soft silicone tube or cord to keep the tear passage open during healing. This tube is not usually noticeable and is removed in clinic about 12 weeks after the operation. The operation takes about 1-1.5 hours, so is NOT a minor procedure. The success rate for this operation is 85-90%. Success means that the watering stops completely or only happens in very windy weather. Surgery stops you having a watery eye that needs wiping all the time. For cure of infection (acute dacryocystitis) the success rate is over 95% - patient will no longer have a painful swelling at the corner of your eye and need frequent courses of antibiotics. Which surgery is better? There is no scar with endonasal DCR, but the scar from external DCR is often invisible after a few months. External DCR is better if the tiny tear ducts in the eyelids (canaliculi) are blocked, as well as the bigger duct in the nose. Endonasal surgery may be better if patient has sinus or other nasal problems -- these may be dealt with at the same time as the tear duct operation. What type of anesthetic is used? The operation will be done under local anesthesia. Most patients stay in hospital overnight but some can go home the same day. After the operation: Patient may have some bleeding from your nose after the operation. Usually, this is only a trickle and more serious bleeding is rare. If there is bleeding at the end of surgery, the surgeon may pack the nostril and the pack is removed the next day. If patient has a nosebleed after he/she has left hospital, it is helpful to pinch the soft part of the nose for at least 10 minutes and place an ice pack on the bridge of the nose. If the bleeding continues it is better to contact the surgeon. The patient should not blow nose hard for two weeks after the operation as this may cause bleeding. After external DCR patient will have a dressing on the side of nose which will be removed next day. Patient may find it difficult to wear your glasses until the dressing is removed. There will be stitches in the cut on the side of nose that will absorb away by themselves. REFERENCE: Evaluation of the Cosmetic Significance of External Dacryocystorhinostomy Scars by Vidushi Sharma, MD (FRCS), Peter A. Martin (FRANZCO), Ross Benger (FRANZCO), Georgina Kourt (FRANZCO), Jenny J. Danks (FRANZCO), Yael Deckel, MD, Geoffrey Hall, MBChB AMERICAN JOURNAL OF OPHTHALMOLOGY, Volume 140, Issue 3, Pages 359.e1-359.e7 (September 2005) For Eye Doctors/Ophthalmologists: We offer various hand-on training courses at SuVi Eye Institute, C 13 Talwandi, Kota, Rajasthan, India. For details please contact suvieye@gmail.com Website: www.suvieye.com; phacolasiktraining.com; Phone +91 9351412449, Phaco Training India, Lasik Laser Training India, Hand on Basic and Advanced Phaco Training India, Customized Lasik Refractive Surgery Training India, Training in Oculoplastic Surgery India, Retinal Lasers Training India, Dr Suresh K Pandey Kota India, Dr Vidushi Sharma Kota India, SuVi Eye Institute Lasik Laser Center Kota India, Medical Retina Training India, Dacryo-Cysto-Rhinostomy (DCR) Training India, C3R (Corneal Collagen Cross Linking with Riboflavin) for Keratoconus Training India, Suture-less Glue Free Pterigium Surgery Training India, Botulinum Toxin Training India, Pediatric Cataract Surgery Training India, Intravitreal Injection Training India, Glaucoma Surgery Training India, Strabismus Surgery Training India, SICS (Small Incision Cataract Surgery)Training India, Manual Phaco Training India, Training in Premium IOL (Multifocal, Toric, Accommodative) India, Phakic IOL, Implantable Contact Lens (ICL) Training India, Keratoprosthesis training India.