Name of the Procedure:

Plastic Repair of Canaliculi (Dacryocystorhinostomy, Canalicular Repair)

Summary

Plastic repair of the canaliculi is a surgical procedure to repair and reconstruct the canaliculi, the small channels in the eyelids that drain tears from the eye into the nasal cavity. This procedure is often necessary when these channels are blocked or damaged due to trauma, infections, or other conditions.

Purpose

The procedure addresses blockages or injuries to the tear drainage system. The primary goal is to restore normal tear drainage and prevent excessive tearing (epiphora) or infections resulting from stagnant tears.

Indications

• Persistent tearing (epiphora)
• Recurrent eye infections or conjunctivitis
• Trauma or injury to the eyelids or canaliculi
• Congenital malformations affecting tear drainage

Preparation

• Patients may need to fast several hours before the procedure.
• Pre-operative assessment including ocular examinations, tear duct irrigation, and imaging studies may be required.
• Adjustments to medications, especially blood thinners, may be necessary.

Procedure Description

1. Administration of local anesthesia to numb the area around the eye, with optional sedation for patient comfort.
2. A small incision is made near the affected canaliculus.
3. Use of fine instruments or microscopic tools to repair or reconstruct the damaged canaliculus.
4. Stenting may be performed to ensure the canaliculus remains open during healing.
5. Suturing the incision closed and placing a small bandage over the area.

Duration

The procedure typically takes about 1 to 2 hours to complete.

Setting

Performed in a hospital operating room or an outpatient surgical center.

Personnel

• An ophthalmic surgeon (specialist in eye surgeries)
• An anesthesiologist or nurse anesthetist
• Surgical nurses or technicians

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Scarring or poor wound healing
• Recurrence of tear drainage issues
• Adverse reactions to anesthesia

Benefits

• Relief from excessive tearing
• Reduced risk of recurrent eye infections
• Improved overall eye health and comfort Benefits are usually realized within a few weeks as healing progresses.

Recovery

• Post-procedure care includes keeping the eye clean and protected.
• Use of prescribed antibiotics or anti-inflammatory medications to prevent infection or reduce swelling.
• Follow-up appointments to monitor healing and remove stents if used.
• Complete recovery may take several weeks, with patients advised to avoid strenuous activities during this time.

Alternatives

• Conservative management with medications (e.g., antibiotics, anti-inflammatory drops)
• Less invasive procedures like probing or balloon dacryoplasty.
• Pros and cons vary by case; less invasive options might be less effective for severe blockages or trauma.

Patient Experience

Patients might feel some discomfort or swelling around the surgical site. Mild pain is usually managed with over-the-counter pain relievers. Vision may be temporarily blurry due to ointment or drops used during healing. Most patients can resume normal activities within a few weeks, following specific care instructions to ensure proper recovery.