If you have had a tear duct surgery called DCR (Dacryocystorhinostomy), I recommend that you should be off work for a minimum 48 hours. However, a lot of people prefer to be off work for about ten days because during the first 7 to 10 days; you may have stitches visible (very tiny) at the corner of the eye in the tear trough.
You will also be quite busy learning to put in eye drops, doing your nasal sprays and especially doing your NeilMed nasal douching twice a day. There can even be a bruise, and so you may want to wear dark glasses. You will also be a little limited on what you can do regarding activities because we do prefer you to take some rest, make gentle exercises such as walking, brisk walking or stationary cycling but nothing more strenuous.
Most patients, if they want to get up and go, take 48 hours off work, and the majority will take off 7 to 10 days. I do not know anyone who takes any longer than that.
After the first visit, patients should come back to visit me after 7 to 12 days after surgery, I will examine your nose and check the wounds, aspirate any packing clots out of the nose endoscopically and then I would remove the tubes at about three weeks after surgery. Removal of tubes is done simply here in the clinic and is only an outpatient visit, so there is no need to still be off work at the time that the tubes are removed.
DCR surgery is becoming like any other oculoplastic operation that it can be done under a local anaesthetic with sedation as a day case and the recovery is quite rapid. The most common complications that the patient can expect in the first few days are bruising around the eye and some bleeding or oozing from the nose. The eye may be still watery because it is swollen inside and with some packing, but as the days’ progress, all swelling gradually improves to give a result of surgery between 90% and 98% success.
After the tubes have been removed, I will then see the lacrimal patient once more when I check the inside of the nose again with the endoscope, making sure that the ostium where the tear duct is now draining is healthy and that I can see tears emerging from the side wall of the nose. I put in a drop of fluorescein onto the surface of the eye, as a coloured tear as it lightens up the tears and makes them much easier to see as a yellow colour in the nose. I can calculate the transit from putting them on the surface of the eye to emerging in the nose and would expect this to be between one second and possibly three to four seconds on occasion.
Once I know that everything is fine and you are at least six weeks after surgery, then we do have the choice of discharging you. Only a small number of patients who have DCR surgery will have a subsequent failure between six weeks and six months. The majority, if they are working well for six weeks, will work well indefinitely.