What is the success rate of DCR surgery?

External DCR has a success rate exceeding 95 percent in experienced hands. Endoscopic (endonasal) DCR success rates are also high, typically ranging from 85 to 95 percent. Success is defined as resolution of tearing and a patent drainage pathway confirmed on irrigation.

External or endoscopic DCR -- which is better?

Both approaches produce excellent outcomes. External DCR offers slightly higher overall success rates and is preferred for complex or revision cases. Endoscopic DCR avoids an external scar and may involve a shorter recovery. The choice depends on the individual anatomy, cause of obstruction, and surgeon expertise.

Is DCR surgery painful?

DCR is performed under general anesthesia or local anesthesia with sedation. Patients typically report minimal pain after the procedure. Mild discomfort, a sensation of nasal congestion, and minor swelling are common in the first few days and are well controlled with standard pain medication.

How long do the silicone stents stay in?

Silicone stents are usually left in place for two to three months to keep the new drainage pathway open while it heals. Removal is a brief, painless office procedure. The stents are generally well tolerated and do not affect daily activities.

Dacryocystorhinostomy (DCR) — Tear Duct Surgery

Kısa Yanıt

Dacryocystorhinostomy (DCR) is a surgical procedure that creates a new drainage pathway between the lacrimal sac and the nasal cavity, bypassing a blocked nasolacrimal duct. It is the gold-standard treatment for nasolacrimal duct obstruction, with success rates exceeding 95 percent. DCR can be performed through an external skin incision or endoscopically through the nose.

What Is Dacryocystorhinostomy?

When the nasolacrimal duct becomes blocked, tears cannot drain from the eye into the nose. This causes persistent tearing, mucous discharge, and a risk of lacrimal sac infection. DCR surgery addresses this by creating a direct opening (ostium) from the lacrimal sac into the nasal cavity through the intervening bone, completely bypassing the obstructed duct. For details on the condition itself, see our tear duct obstruction page.

When Is DCR Recommended?

Complete nasolacrimal duct obstruction confirmed on irrigation
Recurrent acute dacryocystitis (lacrimal sac infections)
Chronic dacryocystitis with mucocele (distended lacrimal sac)
Failed previous lacrimal probing or stenting
Lacrimal sac dacryolith (stone) requiring removal
Functional epiphora with partial obstruction unresponsive to conservative treatment

Surgical Techniques

External DCR

A small incision (approximately 10-12 mm) is placed along the side of the nose, between the inner corner of the eye and the bridge. The lacrimal sac is identified, the adjacent bone is removed to create an osteotomy, and the lacrimal sac mucosa is anastomosed (sutured) directly to the nasal mucosa. Silicone stents are placed through the canaliculi and left in the new passage to maintain patency during healing. The external incision heals within a natural skin crease and becomes nearly invisible.

Endoscopic (endonasal) DCR

The procedure is performed entirely through the nose using an endoscope, with no external incision. The lacrimal sac is accessed from the nasal side; bone is removed with instruments or a drill; and the sac is opened into the nasal cavity. Silicone stents are placed as in external DCR. This approach avoids an external scar and may reduce recovery time. It is particularly useful for patients concerned about visible scarring or who have concurrent nasal pathology that can be addressed in the same session.

Powered endoscopic DCR

A refinement of the endoscopic approach using a high-speed drill or piezoelectric device for precise bone removal and a microdebrider for soft-tissue management. This improves visualization and ostium creation accuracy.

What to Expect on Surgery Day

Anesthesia: General anesthesia or local anesthesia with intravenous sedation, depending on patient preference and surgical plan.
Duration: Approximately 45-60 minutes for a straightforward primary DCR.
Nasal packing: Light nasal packing may be placed and is typically removed within 24 hours.
Discharge: Most patients go home the same day.

Recovery

First 24-48 hours

Mild swelling and bruising around the incision site (external DCR). Nasal packing removed. Avoid nose-blowing and straining. Cold compresses are recommended.

Week 1

External sutures are removed around day 7. Saline nasal rinses are started. Some blood-tinged nasal discharge is normal. Most patients return to desk work.

Weeks 2-4

Bruising resolves. Tearing improves progressively. Nasal crusting is managed with ongoing saline irrigation. Strenuous activity can resume around week 3.

Months 2-3

Silicone stents are removed in a brief office visit. Lacrimal irrigation confirms patent drainage. Final outcome is assessed.

Risks and Limitations

Common and expected

Swelling and bruising around the incision (resolves in 1-2 weeks)
Blood-tinged nasal discharge for several days
Nasal congestion and crusting during healing

Uncommon risks

Ostium closure and failure of the procedure (less than 5 percent for primary external DCR)
Nasal bleeding requiring intervention
Wound infection or granuloma formation at the ostium
Stent displacement or premature loss
Visible scar (external approach -- typically fades to near-invisible)
Need for revision surgery

Ne Zaman Acil Doktora Başvurmalı?

•Heavy or persistent nasal bleeding that does not stop with gentle pressure
•Increasing pain, redness, and swelling at the inner corner (possible wound infection or cellulitis)
•High fever after surgery
•Significant worsening of tearing after stent removal
•Discharge of pus from the incision site or nose

Contact your surgeon promptly if you experience any of these symptoms during the recovery period.

Clinical Note
DCR is one of the most gratifying procedures in oculoplastic surgery because it reliably resolves a genuinely debilitating symptom. The choice between external and endoscopic approaches should be tailored to the patient: external DCR offers the highest success rates and is my preference for primary and complex cases, while endonasal DCR is an excellent option when avoiding a skin incision is a priority or when concurrent nasal pathology needs attention. Regardless of the approach, meticulous mucosal anastomosis and appropriate stenting are the keys to a lasting result.
BA
Op. Dr. Burak Akbay
Göz Hastalıkları Uzmanı | FEBO

Frequently Asked Questions

DCR Surgery Consultation

If you have been diagnosed with a blocked tear duct or experience persistent tearing and discharge, schedule a consultation to discuss whether DCR surgery is right for you.

Call WhatsApp Book Online

Memorial Bahçelievler Hastanesi, İstanbul

References & Sources

American Academy of Ophthalmology (AAO). Preferred Practice Patterns — Oculoplastic Surgery.
European Society of Ophthalmic Plastic and Reconstructive Surgery (ESOPRS). Clinical Guidelines.
Nerad JA. Smith and Nesi's Ophthalmic Plastic and Reconstructive Surgery. 4th ed. Springer; 2021.
PubMed — U.S. National Library of Medicine. Oculoplastic surgery literature.

This page is for general informational purposes only and does not replace medical examination, diagnosis, or treatment. Each patient should be evaluated individually. Treatment decisions can only be made after an in-person consultation.

Results of any surgical or interventional procedure may vary from person to person. The information on this site does not guarantee any specific treatment outcome.

Medical review: Op. Dr. Burak Akbay — Göz Hastalıkları Uzmanı | FEBO

Published: 13 April 2026

Last updated: 13 April 2026