Description & Process
Dacryocystectomy (DCT)
A dacryocyst is a lacrimal (tear) sac. Therefore, dacryocystectomy is excision of the wall of the lacrimal sac. It is indicated as treatment for acute Dacryocystitis. A lump may appear under the skin at the inner corner of the eye as the tear sac fills with pus. If the pus cannot be discharged from the sac by pressing on it, the ducts may be blocked and surgical incision and drainage of the sac is required to relieve the condition.
Dacryocystorhinostomy (DCR)
It is a surgical procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function. A small incision is made on the side of the nose and some bone is removed to make a connection to the nose. Drains are left behind to prevent the gap from closing and are removed after a few months. A Jones or Crawford Tube is placed to facilitate the flow of tears from the eye to the nose.
The operation can also be performed endoscopically through the nose where an opening is fashioned in the lacrimal sac from within the nose. Newer techniques and advances in endoscopic surgery have increasingly made this approach the procedure of choice. The advantages include lesser peri-operative morbidity, no scar and a high success rate.
Laser DCR
If you have been experiencing a watering eye for some time, this is because the duct that normally carries tears away from the eye has become blocked. Laser DCR helps to remove these tears. The procedure involves using a laser to make an alternative channel to allow the tears to drain away properly. This is done by lasering a small hole through from the tear duct into the nasal space. Once the new channel has been made a small tube is passed through to stop it healing up directly after the operation. These tubes may be left in place for 3-6 months. The surgery is usually carried out under a general anesthetic and can take up to approximately 40 minutes. To make sure you are fit enough to undergo the anesthetic you may need to have some investigations such as an ECG (electrocardiogram) and blood tests carried out before the operation.
Canaliculoplasty
Canaliculoplasty involves slitting of the lacrimal punctum and canaliculus for the relief of epiphora.