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Dacryocystorhinostomy/ Nasolacrimal Duct Obstruction

Dacryocystorhinostomy is a procedure to treat watery and sticky eyes caused by narrowing or blockage of the tear drainage tubes. Tears normally drain from the inner corner of our eye into the tear sac and down into the back of our nose. Any blockage in this channel can cause the tears to overflow causing epiphora/watery eyes. During a dacryocystorhinostomy, a new passage is created going around any blockage below the tear sac, between the tear sac and the nose. The same procedure can be modified to treat blockages higher up in the tear drainage system.

Depending on your condition, dacryocystorhinostomy may be performed externally (through the skin) or endoscopically using a transcanalicular laser.

External Dacryocystorhinostomy

During this procedure, a nick is made on the side of your nose to access the tear sac. A small piece of bone is removed from between the tear sac and the nose to get to the inside of the nose. A direct channel is created between the tear sac and the nose by opening the tear sac and stitching it to the lining of the nose. A soft silicone tube is placed in the channel to keep it open while healing occurs. The tube remains hidden and is painlessly removed 6-12 weeks after the procedure.

Transcanalicular Laser

Transcanalicular Laser dacryocystorhinostomy is a minimally invasive endoscopic procedure to treat epiphora. During this procedure, a fibre optic light probe is inserted through the nasal cavity to the lacrimal sac (tear sac). The nasal mucous membrane is excised and an opening is created on the lacrimal sac and upper nasolacrimal duct (tear duct). A small piece of the lacrimal and maxilla bone is removed and an incision is made in the lacrimal sac and nasolacrimal duct. A soft silicone tube is placed to keep the tract open until healing occurs. Compared to external dacryocystorhinostomy, the endoscopic approach helps avoid external scar formation, decreases intraoperative time and bleeding, and creates less damage to the lacrimal pump mechanism.

sydney eye sydney university british columbia franzcoi royal_college anzs ascrs

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