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Medically reviewed by Last updated on Aug 31, 2022.

What do I need to know about a dacryocystorhinostomy (DCR)?

DCR is surgery to help tears drain. It is used when the nasolacrimal duct is blocked. This is the main tear duct that allows tears to drain from the eyes. A new drain system will be created by joining your lacrimal sac with your nasal cavity (inside of the nose). Tears will drain directly into your nasal cavity.

How do I prepare for surgery?

  • Your surgeon will tell you how to prepare. He or she may tell you not to eat or drink anything after midnight on the day before surgery. Arrange to have someone drive you home when you are discharged.
  • Tell your surgeon about all medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • Tell your surgeon about all allergies you have. Tell him or her if you had an allergic reaction to anesthesia or antibiotics.
  • A CT or MRI may be used to check the surgery area. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

What will happen during surgery?

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given local anesthesia to numb the area. You will be awake with local anesthesia, but you should not feel pain. Material soaked in anesthesia may be packed into your nose. The packing may also have medicine to help control bleeding. Packing may also be needed to remove extra mucus.
  • For open surgery, your surgeon will make an incision next to your nose. For endoscopic surgery, your surgeon will put an endoscope into your nose. If he or she has trouble getting to or seeing the area, a septoplasty may be needed. This is surgery to straighten your septum (tissue that separates your nostrils).
  • A small piece of bone will be removed so your surgeon can create a connection between the lacrimal sac and nasal cavity. A stent may be placed to keep the created duct open. If you had an incision, it will be closed with stitches and covered with a bandage.

What should I expect after surgery?

  • Medicines may be given for pain and inflammation. Medicines may also be given to help prevent infection and congestion.
  • Packing made of a gauze dressing may be put into your nose to decrease bleeding. This will be removed 1 to 3 days after your surgery. Bandages will be placed below your nose to catch any blood or fluid that comes out.
  • Swelling or bruising is expected and should get better in a few days. An ice pack will be placed on your nose after surgery to help decrease swelling. You may have nosebleeds for a few weeks after surgery.
  • Nasal rinses help clean your nasal cavity and prevent infection. Healthcare providers will rinse your nose with saline. You will need to use nasal rinses and sprays each day for the first 3 weeks. You will not be able to blow your nose until your healthcare provider says it is okay. The nasal rinses and sprays can help keep your nose clear in the meantime.
  • You may need to wait up to 4 weeks to notice an improvement in your symptoms.

What are the risks of a DCR?

You may bleed more than expected or develop an infection. You may have a permanent surgery scar if your surgeon made an incision. Tissue in your nose may be fused. A tube used to keep the new duct open may fall out or move out of place. Surgery may not work, and you may continue to have watery eyes.

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