What Causes the Need For NLDO Surgery?
Because of age, injury, or chronic disease, the tunnel that drains tears from the eye into the nose can become blocked. Tears may then back up and run down the cheeks and, in some cases, an infection can develop underneath the skin between the eye and the nose (“dacryocystitis”). Many patients complain also of a gooey discharge and eye irritation.
How is NLDO Surgery Performed?
In a nasolacrimal duct obstruction (NLDO) surgery, the passage way that drains the tear is opened with progressive larger probes. A flexible stent tube may be left in place for a few weeks (sometimes longer) to keep the system open. This tube can be removed in the office. The goal of surgery is to eliminate tearing, discharge, and irritation, and reduce the risk of infection.
How Will NLDO Surgery Affect My Vision or Appearance?
A NLDO surgery will not directly affect your vision though many people see better after surgery because they no longer have tearing or discharge from the eyes.
What are the Major Risks of NLDO Surgery?
Risks of NLDO surgery include but are not limited to bleeding, infection, scarring, and spontaneous extrusion of the tube. In addition, the new drainage channel may not stay open; this happens in less than 10% of all cases, and may require additional surgery to correct. There are additional costs if the surgery needs to be repeated or if revisions are required.
What are the Alternatives?
You may decide to live with the tearing, discharge, and irritation that a blocked tear duct can cause. However., if you have had an infection, your surgeon will likely advise surgery to prevent future infections, since these can, in rare circumstances, lead to vision loss. If your tear duct is completely blocked, there is no other surgery, injection, or medicine available to treat this condition. If your tear duct is partially blocked, a balloon can be inflated and/or tubes placed to enlarge the duct and keep it open.
What Type of Anesthesis is Used? What are its Major Risks?
NLDO surgeries can be performed under sedation with local anesthesia (injections around the nose and eye), or under general anesthesia. Risks of anesthesia include but are not limited to damage to the eye and surrounding tissues and structures, loss of vision, breathing problems, and, in extremely rare circumstances, stroke or death.