Scarless surgery: The minimally invasive bypass procedure for blocked tear duct

Chronic sinus or eye infections can lead to a blockage in the tear duct, resulting in a watery and irritated eye when tears can’t drain as usual. In this informative guide to tear duct bypass surgery, highly respected consultant ophthalmologist and oculoplastic surgeon Miss Kimia Ziahosseini shares her expertise on the advantages of minimally invasive surgical approaches and the success rates of procedures of this type.

Why would I need tear duct bypass surgery?

Tear duct bypass surgery, or dacryocystorhinostomy (DCR), is performed when there is an obstruction in the tear drainage apparatus which is causing issues. When your specialist examines you and identifies that there is an obstruction in the drainage system, they would then recommend you undergo a tear duct bypass surgery.

In this procedure, the tear sac (which sits on the side of the nose, next to the eye) is directly opened to the nasal cavity so that the intricate drainage system which is blocked can be bypassed.

What is involved in a scarless endoscopic tear duct bypass procedure?

The medical name for this highly skilled procedure is endoscopic endonasal dacryocystorhinostomy.

Endoscopic means minimal access or keyhole surgery which is, in this case, performed through the nose. This allows the bypass to be created through the nose without disturbing the skin, muscle, and tendon in the area. These structures are crucial to the health and normal function of the eyelids and the eye.

What are the advantages of scarless endoscopic surgery compared to other approaches?

One advantage of undergoing an endoscopic endonasal procedure rather than the traditional skin approach is a lack of scarring, as no incisions are made on the skin. Additionally, the skin, tendon and muscles around the eyes are not disturbed, which in itself is a great advantage.

Using keyhole techniques allows us direct access to the pathology rather than cutting through the skin and the muscles. To perform this type of tear duct bypass surgery special training, expertise and equipment are required which may not be available in every specialist hospital.

How successful is this type of surgery?

Success rates for endoscopic endonasal dacryocystorhinostomy vary in different hands but in the reported literature and within my own practice, are above ninety per cent.

If you are seeking surgical treatment for a blocked tear duct and wish to schedule a consultation with Miss Ziahosseini, you can do so by visiting her Top Doctors profile.