Laser DCR Surgery

DCR, or dacryocystorhinostomy , is a surgery performed to create a new tear drain between the eye and nose when your current tear drain becomes blocked or obstructed.

Conventional DCR surgery is quite long, and complicated. It can involve significant blood loss, which can cause severe complications in a small minority of patients. The requirement for raising a flap of the skin and the subsequent sutures leaves behind a fine scar on the face. There is a significant healing process, and recovery time can be as long as a couple of weeks.

The latest innovation involves the use of a laser which has high absorption in both water and blood. A thin tube is inserted into the punctum, and passed through the canaliculus, till it reaches the position where the new tear drain has to be opened. A very thin optical fiber is then inserted into this tube, and laser energy is delivered to cut through both the bony and soft tissue and into the nose. This opening is then enlarged.  Thus a new tear drain is created. Most of the disadvantages of conventional DCR surgery are avoided. First, the surgery is quick and easy. Second, there is very little likelihood of severe blood loss or severe complications. Third, there is no scar. Fourth, the recovery is immediate. And finally, in case the new drain gets blocked, it can easily be reopened.

Laser DCR is generally performed as an outpatient procedure, which means that the patient does not need to stay in hospital. It is generally done under local anesthesia, which means that the patient is merely sedated with intravenous medications. The patient may need to put some eyedrops for a couple of months. The patient may also need to visit the eye surgeon for a few times for follow-up over the next couple of months.

In some cases, a thin silicone tube may be placed inside the new drain to act as a stent (i.e., to keep the new passage open). This tube is generally removed after a few weeks.