Tear fluid moistening the eye advances from the small channels inside the eye toward the nose. As a result of the obstruction of this channel under the lachrymal sac, this disease appears. Lachrymal duct obstruction is seen mostly on one-year old babies, middle aged or more aged ladies and on individuals with crooked nose structure, and as a result of long-term nasal infection and allergies. Since tear fluid cannot pass to the nose, it flows from eyelid to the cheek. Moreover, lachrymal duct obstruction often causes infection of the eye.

Symptoms of lacrimal duct obstruction and infection

• Excessive tear,
• Frequent ocular discharge
• When nasal root is pressed, inflammation comes to the eye
• Swelling of the nose root.

Treatment of lacrimal duct obstruction in babies

• For the first year, a massage is applied. Massage is applied by pat from nose root towards down. It is necessary that this massage of five minutes should be repeated 3-4 times a day. Possibility of opening of the duct spontaneously is roughly 95 %.
• For ocular discharge of the eye, antibiotic eye drops are used.
• If excessive tear does not pass at the end of the first year, it shows that duct is not opened spontaneously. In this case, “probing” method is applied. If after the first probing, tear problem is not solved; second probing is applied after two months.
• In case excessive tear does not pass after second probing, baby is waited to pass the age of three and surgery named “dacryocystorhinostomy” should be performed.

Treatment of lacrimal duct obstruction in adults

1- Multi Diode Laser

Lachrymal duct surgery with Multi Diode Laser is performed without blood, without any trace in a short time.

Advantages of MultiDiode Laser DSR surgery over other lachrymal duct operations

• The most important advantage of MultiDiode surgery over other methods is the realization of the surgery in a short time as 8-10 minutes.
• In MultiDiode laser, almost there is no bleeding.
• Because of the property of MultiDiode laser, almost there is no tissue injury at the surgery.
• Healing time is quick. Patient can leave the hospital after surgery. The next day after MultiDiode laser operation, patient can return to the social life again.
• No cut on the skin and no damage of muscles around the lachrymal sac are the other advantages.
• To the patients formerly had lachrymal duct operation, second operation with “MultiDiode Laser” provides more success than other methods.
• In treatment with MultiDiode laser all operations can be detected inside the nose with endoscopy. It is possible to interfere if necessary.

2- Dacryocystorhinostomy (Open Surgery)

Under local or general anesthesia, approximately 1 cm cut is made to the nose root.

• A small bone window is opened on the nose bone.
• Direct passage is provided from lachrymal sac to nasal cavity.
• In some cases, silicon may be passed from tube punctums.
• Cut in the skin is closed with sewing and the process is finished.

Complications of Dacryocystorhinostomy Surgery

• Injured place may catch germs
• Channel may be obstructed again (%20)

Report of Dacryocystorhinostomy

• Anesthesia: local or general anesthesia,
• Period: 45 minutes
• Bandage: Eye is bandaged. Bandage is opened the next day.
• After surgery: The swelling around the eye lasts seven days.
• Sewing: Stitches are taken after 7 days.
• Controls: The next day after operation, after 7 days, after 1 month, after 3 months.
• Eye drops and pomade: Pomade with antibiotic on the stitches one week, eye drops with antibiotics to the eye.

What does the success of operation depend on? Can the operation be repeated?

This operation is realized with only ophtalmagists. MultiDiode Laser DSR surgeries are done by doctors specialized on oculoplastic surgery.

The success rate depends on the surgeon performing the operation and his experience. It is essential that the patient has to be examined thoroughly. Success rate of the surgery is more than 90 % for the cases when the operation is done for the first time, and 87.5 % if it is applied to the cases done before with other methods. If it is required, surgery with this method can be repeated. If it is repeated, this rate can be 100 %.