DCR Surgery

[ptlady11]

First of all, I have not had lazik surgery nor do I wear contacts but I am 73 years old. I have had excessive tearing in my right eye and watering in my left eye for a couple of years now. Heard good things about an ENT doctor from another doctor so decided to pay him a visit. He sent me to Opthomologist who did a flushing of right eye...Flushing went through but duct did not stay clear for very long. ENT now has recommended a DCR surgery and I am scared. I don't want to make situation worse than it is but it is uncomfortable and annoying to be socializing with tears runnng down my face not to mention that I have had two infections this year, probably from the constant wiping of the tears from my eyes. Drops do help for a little while. Right now, I have decided not to do any medications except allergy pills to see if allergies are playing a role in this situation. Comments, please. Thanks

[Judy]

Hello ptlady11,

I've had exploratory lacrimal duct surgery done (awake), then two DCR surgeries. My left eye will never be the same. It is so very dry and drips off and on (more in the morning). Or, when I'm at church during the worship music it drips more due to emotions (can't get away with anything!). Anyway, in my case, I think having my lacrimal duct messed with so many times was detrimental. I'm sure there are others that it helped. If you care to read my story see this link: http://www.dryeyezone.com/talk/showthread.php?t=1710

I had some punctal plug issues as well. It was interesting that during the exploratory and DCR surgeries, they never found any plugs, but one erupted out of my lower eyelid (not where the torn punctum is). Very strange. My body took care of it nicely! Anyway, that story is here: http://www.dryeyezone.com/talk/showthread.php?t=4595

DCR may be the answer for you; I hope I'm not too negative due to my own experience. I will say that I don't really mind my eye dripping anymore. I've gotten fairly used to it and apply eye cream once and awhile to help my skin. Take care!

[DCRdryeye]

Don't Have Dcr Surgery

Dear ptlady11,
I am a 38 yr old male who had an endoscopic DCR on my left eye due to 14 months of epiphora (watery eye flowing onto cheek) without success using steroid drops. You can read my story about it in the introduction section titled “Dry eye induced from DCR surgery on a possible Sjogren's sufferer”.
Although I ‘may’ have Sjogren’s, I had DCR surgery. The theory was a lack of tear production possibly ‘dried out’ the nasolacrimal duct thus blocking it…so then epiphora occurred from my left eye. The interesting thing is, before the DCR surgery and before I noticed the epiphora – I DID NOT NOTICE ANY DRY EYE SYMPTOMS AT ALL. My eyes felt completely normal.
Here is an overview of my experience with DCR: I saw two occuloplastic surgeons before DCR surgery and stipulated my defensive nature against surgery. Why such a drastic surgery for a simple “blocked tear duct”?? I saw a surgeon as a private patient and was told DCR is the only way. I specifically told him I want the duct “probed” without having to go through surgery. He said probing and balloon dilatation doesn’t work. Despite my extreme hesitation against surgery he was unsympathetic and said, “Well just live with it then!!!”. I was ushered into the ‘appointment room’ and made a time for surgery. The surgeon was highly recommended and I thought I was in good hands so went ahead with it. Why? I do not know, may-be sick of searching, sick of the tearing, impatient, etc.
The DCR surgery has become a nightmare. It’s created multiple complications including severe dry eye and air regurgitation through the puncta onto the eyeball when I breathe (a common complication of DCR surgery). I was not told anything about these complications, all I was told were the basics (scarring, bleeding, bruising, etc) – well these things occur in ALL surgery, but what about telling the patient specific complications about DCR surgery???? They have an obligation to do so and it didn’t happen with me otherwise I would have disagreed (other complications were possible CSF leakage and corneal abrasion…very serious hey? But they don’t tell you). I was not placed in a position to make an informed decision about surgery. As a result my life has become very difficult with the severe dry eye. I apply Bion tears every 10 minutes, saturate a whole vial of Theratears every hour, Genteal gel, panadeine forte for the ongoing pain from the surgery (yes, I still have pain nearly 12 months after surgery!!!).
It’s the typical ‘cookie cutter’ strategy, they treat patients like we are machines on a conveyer belt. They think they know best and dismiss our emotions. If I was treated with dignity and PROPER PROFESSIONAL care, more attention would have been applied to the “cause” and a schirmer’s test should have been done on the ‘good’ eye, along with a dacryorhinocystogram, etc. But no, is it ‘science or sales’ with these so called professionals? I can tell you this specialist had a very glamorous practice.
ptlady11 I am here to tell you DCR surgery is NOT the only way to unblock a tear duct. In fact DCR doesn’t block a tear duct at all…it creates an artificial tear pathway and the original block remains blocked. With DCR they drill through your bone (something I was never told) and make a gaping big hole in your tear sack…it’s drastic. However, there are minimally invasive alternatives that do not require an operation that DO work. DCR should be the LAST resort. Find a surgeon who will attempt to unblock the natural tear duct blockage (nasolacrimal block). I am assuming your block is further down in the ‘nasolacrimal’ area. If it’s in the canaliculi then DCR surgery is not indicated for you. However, if you have a lower block, do a google search for “nasolacrimal bock intubation”, “nasolacrimal block balloon dilatation”, “adult probing nasolacrimal block”….also use the word “adult epiphora” in your search. A good site to look at is. You may get some useful information from http://www.lacricath.com/images/pdfs...erview_new.pdf and they will put you in touch with someone who uses the lacricath.
I also recommend you demand to have a dacryorhinocystogram which is a scan of your tear duct to see exactly where the block is and whether it’s partial or complete.
There certainly are more conservative surgeons are out there but they are few. Sadly, I found a surgeon interstate in Australia who performs these alternative methods for nasolacrimal blockage AFTER my DCR. He gave them a 60% success rate. However, I’d rather a lower success rate over all the complications of DCR surgery.
ptlady11 I know how it feels to always wipe your eye in public and the irritation it causes to the skin. I also know about waking in the morning with eyelids stuck together from bacteria induced from moisture. However, compared to what I put up with now…it was heaven before DCR surgery.
I will not let them touch my eyes again and thus refuse punctal plugs.
If you have already had the DCR surgery, I wish you all the best and please keep us informed of your progress.
Appologies for raving on about my experience, it’s some emotional ventilation and I want to prevent others going through what I did.

[Judy]

DCRDryEye,

I'm so very sorry for your pain and anguish as your story is so very similar to mine...Judy

[ptlady11]

To Judy and DCRGuy

Fortunately, I did not have the DCR surgery. The endocrinologist who recommended it for me sent me to ophtholomogist (sp) for a second opinion and the ophtholomogist recommended against it. Said I did not have blocked tear ducts and did not need DCR surgery. Instead he has recommended something called Excise Plica semilunaris. He says the Plica is covering the opening to the tear duct (similar to a washcloth covering the drain in the shower) and my tears are backing up and running down my face. He also is going to tighten up my lower eye lid which he says is loose....My surgery is scheduled for 11/18. He will excise the plica and tighten the eyelid. Have you ever heard of this? Ptlady 11

[DCRdryeye]

ptlady with new diagnoses

I'm so relieved they got your diagnoses correct this time. If the syringing flowed through then you don't have a blocked tear duct. You have a different problem and it seems more age related. Eye lid laxity is common with ageing and the 'punctum' is also being blocked.
I did a bit of research on excision of Plica semilunaris and it seems straight forward and far less invasive than DCR. You'll also find if they tighten the eyelid laxity the punctum will be closer to the eyeball where it needs to drain your tears into your nose.
Good on you for being cautious and patient, and good luck for the surgery. Please let us know how it all goes.

[ptlady11]

DCR Dry Eye

Thanks so much for your kind encouragement and for your research.....Age related makes sense...just turned 74 ...Hope it works....seems much less invasive than the DCR surgery. The way you described it is just how the Doctor described it.......Thankful to the Endocrinologist who was to do the DCR for sending me to the eye doctor for a second opinion........I lucked out there because I did not know any better.......Thanks again for your help. Surgery to be performed 11/18.......scared!!

[ptlady11]

All is Well

Surgery went fine. Seems wonderful to have my eyes almost normal......Now I just have to worry about cataracts!! Thanks to DCR Guy and Judy for advise. I really appreciated your taking the time

[Lucy]

This is a very interesting and informative thread! Lucy

[DCRdryeye]

Surgery went fine. Seems wonderful to have my eyes almost normal......Now I just have to worry about cataracts!! Thanks to DCR Guy and Judy for advise. I really appreciated your taking the time

Glad to hear it went well for you it shows what patience and an accurate diagnoses can do. As for the cataracts, I believe the onset can be delayed using nutrition and herbs. Antioxidants and bioflavonoids can play a role, perhaps do a google search? However careful with self prescribing, especially if on prescription meds like blood thinners, etc. A nutritionist or naturopath can really help
All the best....

[Judy]

I'm so glad to hear things are going well for you!! Merry Christmas/Happy New Year! God Bless!

[tearydeary]

DCR quandary!

Hi everyone I am new to this site and would like to thank everyone for such valuable info/feedback on the DCR debate!
I have endured a chronically blocked tearduct for the past decade....it is now constant..ouch! The first Opthalmic surgeon took one look, had his helper perform a lacrimal washout then simply told me I required surgery (DCR). This sent me into a bit of a tailspin because he was quick to have me 'booked in' and quoted a rather exorbitant fee, I decided to think it over first, (had a distinct 'Mr businessman' impression of the surgeon)!
Sought a second opinion and joy of joys this equally well qualified man suggested with my medical history, there is a very good chance that my problem could be caused by nasal polyps...let's investigate...yay!!! Well he has sugested a probe of the offending tearduct and an ENT referal if required...DCR would be the last option and totally useless if in fact there is an underlying ENT issue...Having the probe performed under light sedation in the Surgeons rooms at virtually no cost to me then further investigation if required...will keep you informed as I have found this site invaluable...especially DCR dryeye, thank you so much for sharing your story it really alerted me to the potential pitfalls and actually prompted me to seek a second opinion! So thanks again! LOL

[DCRdryeye]

Hi everyone I am new to this site and would like to thank everyone for such valuable info/feedback on the DCR debate!
I have endured a chronically blocked tearduct for the past decade....it is now constant..ouch! The first Opthalmic surgeon took one look, had his helper perform a lacrimal washout then simply told me I required surgery (DCR). This sent me into a bit of a tailspin because he was quick to have me 'booked in' and quoted a rather exorbitant fee, I decided to think it over first, (had a distinct 'Mr businessman' impression of the surgeon)!
Sought a second opinion and joy of joys this equally well qualified man suggested with my medical history, there is a very good chance that my problem could be caused by nasal polyps...let's investigate...yay!!! Well he has sugested a probe of the offending tearduct and an ENT referal if required...DCR would be the last option and totally useless if in fact there is an underlying ENT issue...Having the probe performed under light sedation in the Surgeons rooms at virtually no cost to me then further investigation if required...will keep you informed as I have found this site invaluable...especially DCR dryeye, thank you so much for sharing your story it really alerted me to the potential pitfalls and actually prompted me to seek a second opinion! So thanks again! LOL

Oh dear, it seems tearydeary is no longer a member here, I haven't logged in for ages since nothing new has come about for dry eye. I would have liked to know what her progress was.
I feel so sorry for patients who are bullied into unecessary operations then live with complications for the rest of their lives (like myself)...I'm glad at least my story prompted tearydeary to get a second opinion.