DACRYOCYSTORHINOSTOMY
What is Dacryocystorhinostomy? Type of anesthesia
Dacryocystorhinostomy is a surgical procedure that consists of creating a new drainage duct with the patient’s own tissue in cases of tear duct obstruction. These are located between the eye and the nose and allow evacuation of tears from the eye, but can sometimes become obstructed. If this happens, the tears are not drained internally and the tears are drained externally, causing constant tearing or watery eyes.
Through dacryocystorhinostomy, then, the communication between the lacrimal sac and the nostrils is restored by creating a new duct. It is an outpatient procedure performed under local anesthesia and sedation.
Why is it performed?
Dacryocystorhinostomy is performed in patients with tear duct obstruction and, as a consequence, excessive tearing.
What does it consist of?
During the procedure, the ophthalmologist places silicone tubes temporarily in the tear duct. These tubes act as a mold of the new tear duct, so that the tear can drain well when the postoperative period is over.
There are several types of dacryocystorhinostomy:
- Laser dacryocystorhinostomyà By means of an optical fiber that is in contact with the internal wall of the lacrimal sac, a series of laser impacts are made that help in the creation of the new duct. It is an innovative technique, as no scars are created.
- External dacryocystorhinostomy is performed through the skin at the base of the nose. It is not a widely applied technique, so it is reserved only for cases in which the laser technique does not solve the problem.
- Internal (endonasal) dacryocystorhinostomy à The surgery is performed by encoscopy via the nose. The advantage is that incisions in the skin are avoided and, in addition, it allows to treat, in some cases, other nasal pathologies, such as sinusitis, polyps, aspergilloma…
Preparation for Dacryocystorhinostomy
Prior to Dacryocystorhinostomy should be performed:
- An ophthalmologic examination and examination of the palpebral and periocular area.
- An irrigation of the lacrimal duct in consultation. This is done by injecting a saline solution under pressure into the lacrimal duct to locate the obstruction.
- A dacryoscintigraphy (functional contrast test of the lacrimal ducts), sometimes necessary.
Care after the operation
After the operation the ophthalmologist occludes the patient’s operated eye for 24 hours, after which time it will be checked. It is usually accompanied by a nasal packing during the first day.
During the postoperative period the patient must follow an oral and topical antibiotic and anti-inflammatory treatment. However, the discomfort of the laser procedure is very little.
Two weeks after the procedure, the patient will be checked again by the ophthalmologist to evaluate and control the healing and permeability of the tear duct.
The results will be seen about a month and a half after surgery.