Name of the Procedure:

Incision and drainage of the lacrimal sac (Dacryocystotomy or Dacryocystostomy)

Summary

This procedure involves making a small incision in the lacrimal sac (part of the tear drainage system) to drain pus or relieve an obstruction caused by infection or blockage.

Purpose

This procedure is done to address nasolacrimal duct obstruction or infection (dacryocystitis). The goal is to relieve pain, reduce swelling, and restore normal tear drainage.

Indications

• Persistent tearing (epiphora)
• Recurrent eye infections
• Swelling or pain in the corner of the eye
• Presence of pus or mucous discharge from the eye
• Failed non-surgical management

Preparation

• Fasting for a few hours prior to the procedure if sedation will be used
• Adjustments to certain medications (e.g., blood thinners)
• Preoperative evaluation including medical history and physical examination
• Possible imaging studies to assess the extent of the blockage

Procedure Description

1. Local anesthesia is administered to numb the area; sedation may be used if necessary.
2. A small incision is made near the lacrimal sac.
3. The surgeon drains the accumulated fluid or pus.
4. The area may be irrigated with saline to clear any remaining blockage.
5. A stent may be placed temporarily to keep the duct open during healing.
6. The incision is closed with sutures, if needed.

Duration

Approximately 30 to 60 minutes.

Setting

Typically performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Ophthalmic surgeon or oculoplastic surgeon
• Nurse
• Anesthesiologist (if general anesthesia or sedation is used)

Risks and Complications

• Infection at the incision site
• Bleeding
• Scarring
• Blockage recurrence
• Damage to nearby structures
• Adverse reactions to anesthesia

Benefits

• Relief from chronic tearing and infection
• Reduced pain and swelling
• Improved eye function and comfort
• Most patients experience noticeable improvement shortly after the procedure.

Recovery

• Apply prescribed antibiotic ointment or drops to prevent infection
• Avoid touching or rubbing the incision site
• Follow a short course of antibiotics
• Expect mild discomfort or swelling for a few days
• Full recovery usually occurs within 1 to 2 weeks
• Follow-up appointments to monitor healing

Alternatives

• Non-surgical management with warm compresses and antibiotics
• Balloon catheter dilation
• Laser-assisted procedures
• Dacryocystorhinostomy (more invasive surgery to create a new passage for tear drainage)
• Each alternative has its own advantages and disadvantages regarding effectiveness, recovery time, and risk.

Patient Experience

• During the procedure, the patient may feel pressure but should not feel pain due to anesthesia.
• Mild discomfort, swelling, and bruising can be expected post-procedure.
• Pain is usually managed with over-the-counter pain relievers.
• Most patients report significant relief from symptoms soon after the procedure.