OverviewExternal DCR SurgeryEndoscopic DCR SurgeryPatient instructions
FAQRemoval of tubesFollow-up visitsNICE Guidelines

Frequently Asked Questions

1. Which surgery will I have?

The external approach has a higher success rate than the internal approach. Around 90% of external DCR operations are successful. Surgical failure is due to formation of scar tissue. The disadvantage of the external approach is that there is a small skin scar on the side of the nose which is occasionally visible in some patients. The advantage of the internal approach is that it is a quicker procedure and there is no skin scar with this method. The surgical success rate of this approach is slightly less than that of the external, in a range of 80 - 85%. Both surgical approaches can be done either under general anaesthesia (patient asleep) or local anaesthesia (patient awake) where only the surgical zone is "frozen". The surgeon will recommend which type of surgery they believe is best for you.

2. What happens before surgery?

In the clinic your tear passages will be assessed by syringing salty water through the tear ducts to determine where and how much of a block there is. The nose is sprayed with a local anaesthetic and inspected using an endoscope. Sometimes we will request other investigations, such as a special x-ray dacryocystogram or lacrimal scintigraphy.

If you are on Warfarin or Aspirin tablets it is important that the inform the clinic doctor, as these may lead to bleeding during the operation. Usually we ask patients to discuss the Warfarin with their GP or hospital physician, but not to stop it. We prefer patients to stop their Aspirin tablets two weeks before the surgery, as otherwise this can cause bleeding.

3. What happens after surgery?

You will be asked to put in eye drops 3 -4 times a day for up to one month. Sometimes a nasal spray will be used twice a day for a similar time. You should not blow your nose for 5 - 7 days after surgery, but after this we advise you to blow your nose a lot to blow out the crusts which have accumulated.

The first clinic appointment is 1 - 3 weeks after surgery and the second 6 - 8 weeks after surery to remove the tubes. A final check is usually made six months after surgery. If everything is successful you are then discharged.

See also the post operative instructions