DCR and Closed Intubation

Types of DCR Procedures

1. External DCR: The surgeon creates a small incision between the eye and nose to access the tear sac directly. This method provides clear access for complex blockages.
2. Endoscopic DCR (Closed DCR): No external incision is made; instead, an endoscope is used through the nose to perform the surgery. This method reduces visible scarring and has a shorter recovery time.

Closed Intubation for Tear Duct Blockage

Closed intubation is a minimally invasive procedure often chosen for partial tear duct blockages. A tiny silicone tube is inserted into the tear duct system to create a new, open pathway for tears to drain.

When is Closed Intubation Recommended?

Closed intubation is often recommended when DCR may be unnecessary, such as in cases where:

• The tear duct blockage is partial or intermittent.
• The patient has previously undergone DCR but requires additional help to maintain tear flow.
• Minimally invasive options are preferred for faster recovery.

This procedure may be paired with balloon dacryoplasty, where a small balloon is inflated to widen the duct, making it effective for mild to moderate blockages.

Symptoms of Tear Duct Blockage

• Constant tearing (epiphora)
• Discharge from the eye
• Swelling near the inner corner of the eye
• Recurrent eye infections or dacryocystitis
• Pain or discomfort in the tear sac area

If you experience any of these symptoms, it’s essential to consult with our eye care specialists at Visualis Eye Clinic for an accurate diagnosis and treatment plan.

How is DCR Performed?

1. Diagnosis and Imaging: Before recommending DCR, we conduct a detailed exam, which may include imaging to understand the tear duct anatomy and blockage location.
2. Procedure: In an external DCR, an incision is made along the side of the nose, allowing access to the tear sac, which is then connected to the nasal cavity. In an endoscopic DCR, the surgeon operates through the nasal passage with the aid of an endoscope.
3. Post-Procedure Care: Silicone tubes may be temporarily placed to help keep the new drainage pathway open. These tubes are removed after several weeks during a follow-up visit.

How is Closed Intubation Performed?

1. Initial Assessment: Our specialist evaluates the severity of the tear duct blockage and discusses if closed intubation is a suitable option.
2. Procedure: A small silicone tube is gently inserted into the tear duct to create a stable drainage pathway. In some cases, a balloon catheter may be used to widen the blocked duct.
3. Follow-Up Care: After a few months, the tube is removed to assess the success of the procedure.

Recovery and Aftercare

Post-procedure care is crucial for both DCR and closed intubation:

• Swelling and Discomfort: Some mild swelling and discomfort are normal and usually subside within a week.
• Antibiotic Eye Drops: You may be prescribed antibiotic drops to prevent infection during recovery.
• Avoid Rubbing the Eyes: It’s essential to avoid any pressure on the eyes while the healing process takes place.
• Regular Follow-Ups: Follow-up appointments help ensure proper recovery and check for any signs of infection or obstruction.

Risks and Complications

Both DCR and closed intubation are generally safe procedures, but as with any surgery, there are potential risks:

• Infection in the operated area
• Mild bleeding
• Scar tissue formation in the nasal cavity (rare in endoscopic DCR)
• Recurrence of tear duct blockage

Our skilled team at Visualis Eye Clinic takes all necessary precautions to minimize these risks and ensure a smooth recovery.

Choosing the Right Procedure

Our ophthalmologists at Visualis Eye Clinic will evaluate the cause, severity, and location of your tear duct blockage to recommend the best treatment approach. Whether it’s DCR or closed intubation, we are here to provide you with personalized care and support every step of the way.