What happens after DCR surgery?
After DCR surgery to relieve a watering eye, the area inside the nose and often on the skin has to be cured. There may be some little stitches in the tear trough, which come out in one week. The nose is packed at the end of the surgery, and that has to be either blown out after a week or removed by the surgeon. The patient after DCR surgery is kept quite busy for the first week because they have to do eye drops, nasal sprays and nasal douche with NeilMed sinus rinse, several times a day.
During DCR surgery, a small opening is made from the lacrimal sac, deep within the corner of the eye, and into the nose, through which the tears can drain well. The DCR operation is very delicate and effective with over a 95% success rate. However, the aftercare is just as important as the surgery. The oculoplastic surgeon will direct the patient on how often the drops have to go in, how often nasal sprays have to be used and also give an information sheet on how to use the NeilMed nasal douche. The douche will clear out some of the packing and any blood clots from inside the nose after the surgery, and also makes the nose feel very fresh and clean.
At the end of the DCR surgery, the oculoplastic surgeon will often put a little silicone tube through the system from the corner of the eye into the nose. These are often known as “the tubes” or “the silicone tubes”. In fact, it is one loop of the tube, where we see loop at the corner of the eye at the medial canthus and the two ends of what is a long piece of the tube are knotted together in the nose to secure them so that they do not dislodge. “The tubes” help keep everything open while there is healing and can be removed quite delicately and traumatically in the clinic as an outpatient roundabout three weeks after DCR surgery. The patient is not usually aware that they have silicone tubes. Sometimes while the tubes are in the eye is still a little watering, and once removed the watering goes completely.
If a tiny skin incision has been done, as in for instance LighTears DCR or COEXEN DCR, then those stitches would have been removed roundabout one week and the tear trough incision will heal very rapidly. In fact, most of the patients that I see already have an almost invisible incision site by two weeks after surgery.
After DCR surgery there can be some bruising below the eye. That can be alarming. To begin with, I always suggest patients that they may have a small bruise on the side of the nose and on the cheek which will then descend the cheek over the next five to ten days and then disappear. The speed of which different people clear a bruise varies; some people with clear a bruise within three or four days and some can even take up to 21 or 22 days.
There are certain do’s and don’ts after DCR surgery which I will list here:
- Do not blow the nose for one week
- Do not lean down or go upside down or carry heavy shopping
- Do not swim
- Do not do excessive sports
- Do not take any other tablets that can thin the blood either before, on the day, or for five days after surgery, taking care to have stopped aspirin before the surgery and for five days after the surgery
- You should sleep with three or four pillows for the first few nights so as to keep the level of the head above the heart as that helps to reduce swelling
- You should go for regular walks after 48 hours to get the circulation going and help the healing
- You should eat a healthy diet and rest as much as possible during the first week
- You may fly after 48 hours
- You may have your hair done as long as you lean back at the hairdressers and then to wash it.
Patients having DCR surgery at Clinica London always get a full information sheet before the surgery about what to expect and also instructions for their aftercare.