Unblocking the tear ducts can be done in many ways. Probing the tear ducts is the most common method in children and infants. On the other hand, in adults, the possibilities of opening the tear ducts are much greater. We can choose the classic, endoscopic and the most modern, i.e. laser methods. Check how to unblock the tear ducts.
OperationalOpening the tear ducts in adults ,childrenandinfantsis sometimes the only way to to keep the eyes from watering too much. Congenital obstruction of the tear ducts is the most common cause of obstructed tear ducts in newborns, infants and young children. Fortunately, most children experience restoration of the tear ducts spontaneously or after massage or topical antibiotics. If these methods of treatment do not help, lavage and probing of the tear ducts are performed. In adults, the classic (dacrocystorhinostomy), endoscopic and laser methods can be used.
Classic method (dacrocystorhinostomy - DCR)
The procedure consists in making an incision in the medial angle of the eye to a length of about 15 mm, and then creating a fistula above the obstruction. Then the doctor introduces special tubes into the tear ducts to maintain the patency of the resulting fistula. Finally, it sutures the cut tissues in layers.
Dakrocystorhinostomia is considered the most effective (90-95%) method of restoring tear ducts, incl. because it allows the doctor to have an excellent overview of the operated area, and therefore can know the exact cause of the obstruction of the tear ducts. In addition, a dacrocystorhinostomy can be performed with any type of obstruction.
However, a small scar remains after the procedure. In addition, there are subcutaneous haemorrhages at the site of anesthesia administration.
Endoscopic lacrimal drainage (EDCR)
Endoscopic lacrimal drainage (EDCR) involves inserting an endoscope and creating a connection between the lacrimal sac and nose above the tear duct block (the endoscope is inserted through the nose). The last stage of the procedure is the installation of silicone tubes.
Temporary insertion of silicone tubes into the tear ducts has been the rule in operations for yearsreconstructive tear ducts
During endoscopic restoration of the tear ducts, it is not necessary to make an incision in the skin, therefore there are no scars left after the procedure. In addition, local anesthesia is performed only from the nasal cavity (and not from the side of the inner eye angle, as in the case of the classic method), therefore the risk of swelling and haemorrhage at the site of anesthesia administration is low.
However, this method also has disadvantages as it is limited to certain occlusions of the tear duct. In addition, the effectiveness of the treatment is estimated at about 80-90 percent. (which means that another operation may be necessary).
Laser microendoscopy (transubular laser dacrocystorhinostomy - LDCR)
The procedure involves the insertion of a microendoscope with a diameter of 0.5 mm connected to the laser fiber through the lacrimal canal into the lacrimal sac. After reaching the site of the obstruction, the doctor uses laser light to recreate the tear ducts. The next part of the procedure is inserting a silicone tube into the tear duct that flows out into the nasal cavity. Tubes are removed 6 months after the procedure.
Trans-tubular laser dacrocystorhinostomy is the most modern and minimally invasive method of clearing the tear ducts
The procedure takes about 20 minutes and the patient is released home 1-2 hours after its completion. He may return to work the next day.
In this case, there are also no scars and local anesthesia is performed only from the nasal cavity, which reduces the risk of bruising.
The effectiveness of this method is approximately 80-85 percent. In addition, the procedure is very expensive (it is not reimbursed by the National He alth Fund) - the price is about 5,000. PLN for one eye.
Unblocking the tear ducts with ballooning
This method consists in widening the narrowed but obstructed nasal passage with a balloon. Due to the fact that the effectiveness of this procedure is questionable (it is estimated at 50%) and the cost of its performance is high, it is rarely chosen as a method of treating obstructed tear ducts.