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Surgery for TearingPunctal OcclusionPunctal occlusion is used to close the opening of the tear drainage duct (punctum), so the few tears that are produced are in your eye longer, thus alleviating dry-eye symptoms. The opening of the tear duct is numbed by a topical anesthetic held in place for a few minutes. A temporary collagen punctal plug can be placed in the tear duct to determine if this alleviates dry eye symptoms. The collagen plug dissolves naturally in one to two weeks. A more permanent silicone plug can then be instilled if the results are positive or opening of the tear duct can be permanently closed by an instrument that causes scarring of the opening. Antibiotics in the eye are used twice a day for a few days to a week. Swelling is minimal, and most patients can resume their normal activities right away. Probe & IrrigationProbing and irrigation is used to determine if the drainage system for tears (lacrimal duct system) is open. If the drainage system is narrowed at any point, sometimes a probing and irrigation will open up the narrow area and the tearing symptoms may improve. Dacryocystorhinostomy (DCR)If the natural drainage system is damaged, a bypass can be made for the drainage of tears from the eye to the nose. The external approach for DCR uses a small incision on the skin at the side of the nose and a small piece of bone is removed. A stent is then placed to keep the opening from closing. The skin is then closed over, and most patients heal with very minimal scarring. The internal, or endoscopic, approach uses a video camera to guide the surgeon from the nostrils to the lacrimal sac. A small incision is made and a small piece of bone from the lacrimal sac is removed. Stents are then placed to keep the opening from closing. Stents from both approaches are usually kept in place for a total of 3-6 months. Return to Conditions & Treatments Page
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