Best Advanced Endoscopic Dacryocystorhinostomy (DCR)
A Modern Solution for Blocked Tear Ducts
What Is Endoscopic DCR?
Endoscopic Dacryocystorhinostomy (DCR) is a minimally invasive surgical procedure used to treat nasolacrimal duct obstruction (NLDO)—a condition where the tear drainage system becomes blocked, leading to excessive tearing (epiphora), recurrent eye infections, and inflammation of the tear sac (dacryocystitis).
Instead of making an incision on the skin (as in external DCR), endoscopic DCR uses an endoscope—a small, thin, lighted instrument inserted through the nostril to create a new tear drainage pathway between the lacrimal sac and the nasal cavity.
Endoscopic DCR is a transnasal surgical procedure that bypasses an obstructed nasolacrimal duct by creating a direct opening between the medial wall of the lacrimal sac and the lateral nasal wall, typically at the level of the middle turbinate, under endoscopic visualization.
Symptoms That May Require Endoscopic DCR Surgery
Endoscopic Dacryocystorhinostomy (DCR) is performed to treat a blocked tear duct (nasolacrimal duct obstruction or NLDO). If you’re experiencing the following symptoms, you may be a candidate for this surgery:
1. Excessive Tearing (Epiphora)
Tears constantly overflow onto the cheek due to improper drainage.
2. Recurrent Eye Infections
Repeated infections in the inner corner of the eye, also known as chronic dacryocystitis.
3. Pain or Swelling Near the Nose or Inner Eye
Infection and inflammation cause tenderness in the tear sac (lacrimal sac area).
4. Blurry Vision
Persistent tearing or discharge can blur your vision.
5. Mucous or Pus Discharge from the Eye
Especially when pressure is applied to the inner corner.
6. Redness of the Inner Corner of the Eye
Indicates inflammation due to stagnant tears.
7. Recurring Styes or Chalazia
These may be a secondary complication due to tear stasis and bacterial buildup.
Causes Leading to the Need for Endoscopic DCR
A blocked tear duct is the root cause that leads patients to require endoscopic DCR surgery. Several conditions can cause or contribute to this blockage:
1. Age-Related Narrowing
The tear ducts may naturally narrow or close with age, especially in adults over 40.
2. Chronic Infections
Long-term infections of the tear duct or surrounding structures can cause scarring and obstruction.
3. Nasal or Sinus Disorders
Conditions like chronic sinusitis, nasal polyps, or a deviated nasal septum may affect the drainage of the tear system.
4. Inflammatory Diseases
Autoimmune disorders such as sarcoidosis, Wegener’s granulomatosis, or lupus can cause inflammation of the tear duct system.
5. Facial Trauma or Surgery
Previous facial injuries, nasal surgeries, or sinus surgeries can damage or scar the nasolacrimal duct.
6. Tumors or Cysts
Benign or malignant tumors in the nose, sinuses, or lacrimal sac can block the tear passage.
7. Congenital Blockage
Some individuals are born with a narrowed or completely blocked tear duct.
8. Pediatric Causes
In infants, congenital nasolacrimal duct obstruction may persist and eventually require surgery if it doesn’t resolve with time or probing.
Summary
You Might Need Endoscopic DCR Surgery If You Experience:
- Chronic watery eyes
- Pain and swelling near the inner eye
- Frequent eye infections or mucous discharge
Common Causes of Tear Duct Blockage:
- Age-related narrowing
- Chronic infections or inflammation
- Facial trauma or surgeries
- Tumors, cysts, or structural nasal abnormalities
If you’re facing any of these symptoms, a consultation with an oculoplastic surgeon or ophthalmologist is essential. In Mumbai, Dr. Shahnawaz Kazi at Ashu Laser Vision & Ashu Eye Hospital is a leading specialist in Endoscopic DCR surgery with advanced diagnostics and minimally invasive care.
Procedure Overview: How Endoscopic DCR Is Performed
1. Anesthesia
- Local anesthesia with sedation or general anesthesia is administered.
- Nasal decongestant drops are applied to minimize bleeding.
2. Endoscope Insertion
- A nasal endoscope is inserted through the nostril.
- The nasal mucosa is lifted to expose the bone over the lacrimal sac.
3. Creation of Bony Window
- A small part of the lacrimal bone and frontal process of the maxilla is removed.
- This exposes the medial wall of the lacrimal sac.
4. Formation of New Tear Drainage Pathway
- An opening (ostium) is made in the sac wall to allow direct drainage of tears into the nasal cavity.
5. Insertion of Stents (Optional)
- A thin silicone stent or tube may be placed to prevent closure of the new passage.
- The stent is usually removed after 4–6 weeks.
6. Completion
- Bleeding is controlled.
- Nasal packing may be used temporarily.
Types of Endoscopic DCR
- Primary Endoscopic DCR
First-time surgery for tear duct blockage. - Revision Endoscopic DCR
For patients with failed external or previous endoscopic DCR. - Balloon-Assisted Endoscopic DCR
A balloon catheter is used to dilate the new tear passage. - Laser-Assisted Endoscopic DCR
A laser (such as diode or KTP) is used to create the new passage—less commonly used than manual bone removal.
Advantages of Endoscopic DCR
- No visible facial scar (performed through the nostril)
- Preserves the natural lacrimal pump mechanism
- Faster recovery time compared to external DCR
- Less postoperative discomfort and bruising
- Precise visualization using high-definition endoscopy
- Suitable for bilateral procedures in the same session
Risks and Complications
Like any surgery, Endoscopic DCR carries some risks:
- Minor nasal bleeding (common and usually self-limiting)
- Infection (rare)
- Failure to relieve tearing (due to restenosis or granulation)
- Adhesion formation (synechiae)
- Stent-related irritation or displacement
- Rare damage to adjacent structures (e.g., medial rectus muscle or orbital fat)
Postoperative Care & Recovery
Immediately After Surgery:
- Mild discomfort or nasal congestion
- Temporary nasal packing for bleeding control (removed in 24–48 hours)
First Few Weeks:
- Use of antibiotic and steroid eye drops
- Saline nasal irrigation to keep the nasal passage clean
- Avoid nose blowing, straining, or heavy lifting
Stent Removal:
- If placed, silicone stents are removed after 4 to 6 weeks in the clinic.
Full Recovery:
- Most patients recover in 2 to 4 weeks
- Success rate: 90–95% in primary surgeries
Where to Get Endoscopic DCR in Mumbai?
Ashu Laser Vision & Ashu Eye Hospital – Andheri West, Mumbai
Recognized as one of the best eye hospitals in Mumbai for Endoscopic DCR surgery, Ashu Eye Hospital is led by Dr. Shahnawaz Kazi, a specialist in:
- Oculoplastic surgery
- Retina and laser eye procedures
- Lacrimal disorders and tear duct reconstruction
Best Endoscopic DCR Surgery in Mumbai – Ashu Eye Hospital & Ashu Laser Vision
If you are struggling with chronic watery eyes, frequent eye infections, or a blocked tear duct, Endoscopic Dacryocystorhinostomy (DCR) might be the most effective treatment for you. In Mumbai, Ashu Eye Hospital & Ashu Laser Vision, located in Andheri West, is renowned for offering the best Endoscopic DCR surgery, combining advanced technology with personalized care.
About Ashu Eye Hospital & Ashu Laser Vision, Mumbai
Ashu Eye Hospital is a state-of-the-art super-specialty eye care center in Andheri, Mumbai, specializing in laser vision correction, retinal disorders, and oculoplastic surgeries such as Endoscopic DCR. The facility is equipped with the latest endoscopic systems, laser technology, and a dedicated operating suite for delicate eye and nasal surgeries.
Dr. Shahnawaz Kazi – Expert in Endoscopic DCR Surgery
Dr. Shahnawaz Kazi, the founder and chief surgeon at Ashu Laser Vision, is an experienced ophthalmologist and oculoplastic specialist. With expertise in treating nasolacrimal duct obstruction, he has performed numerous successful Endoscopic DCR procedures with high success rates and minimal downtime.
Why Patients Trust Dr. Kazi for Endoscopic DCR:
- Specialist in oculoplastic and reconstructive eye surgery
- Experienced in both primary and revision DCR surgeries
- Focus on scar-free, minimally invasive techniques
- Offers personalized preoperative and postoperative care
Ashu Laser Vision and Ashu Eye Hospital in Andheri, Mumbai, is a top choice for scarless, minimally invasive Laser DCR surgery, led by Dr. Shahnawaz Kazi, a highly experienced specialist in advanced tear duct surgeries.
For those seeking the best Endoscopic DCR surgery in Mumbai, Ashu Laser Vision & Ashu Eye Hospital stands out for its blend of medical excellence, modern technology, and compassionate care. Under the leadership of Dr. Shahnawaz Kazi, patients receive expert guidance, safe surgical treatment, and excellent results.
LASER DCR
What is Laser DCR (Laser Dacryocystorhinostomy)?
Laser DCR is a minimally invasive surgical technique used to treat nasolacrimal duct obstruction (NLDO)—a condition where the tear drainage system is blocked, causing excessive tearing (epiphora), eye infections, and inflammation. In Laser DCR, instead of using traditional surgical instruments, a laser is used to create a new tear drainage pathway between the lacrimal sac and the nasal cavity.
It is a scarless, quicker recovery alternative to conventional (external or endoscopic) DCR surgery.
How is Laser DCR Performed?
- Anesthesia: Performed under local or general anesthesia.
- Endoscopic Access: A nasal endoscope is inserted through the nostril to access the lacrimal sac.
- Laser Application: A laser (commonly diode, KTP, or CO2 laser) is used to precisely cut the bone and soft tissue between the sac and the nasal cavity.
- Drainage Path Creation: A new opening (ostium) is made to allow tears to drain directly into the nose.
- Silicone Tube (Optional): A silicone stent may be placed temporarily to keep the passage open during healing.
Advantages of Laser DCR
- No external scar – completely done through the nose
- Minimal bleeding due to laser cauterization
- Faster recovery and shorter surgical time
- Less postoperative discomfort
- Reduced hospital stay – often done as a day-care procedure
- Precise cutting with less trauma to surrounding tissues
Limitations & Considerations
- Less effective in severely scarred or infected cases
- May have a slightly lower long-term success rate compared to traditional endoscopic or external DCR
- Not ideal for patients with significant nasal pathology (e.g. deviated septum, polyps)
- May require revision surgery in case of closure or restenosis
Where Can You Get Laser DCR in Mumbai?
Ashu Laser Vision & Ashu Eye Hospital – Andheri West, Mumbai
Led by Dr. Shahnawaz Kazi, Ashu Eye Hospital specializes in scar-free laser-assisted DCR for patients suffering from blocked tear ducts. They use advanced endoscopic laser systems and offer both primary and revision tear duct surgeries.
FAQs for Endoscopic DCR (Endoscopic Dacryocystorhinostomy) & LASER DCR (Dacryocystorhinostomy)
Endoscopic DCR is a minimally invasive tear duct surgery that creates a new drainage pathway from the lacrimal sac to the nasal cavity using an endoscope, without any external scars.
This surgery is recommended for patients suffering from chronic watery eyes, tear duct blockage (NLDO), recurring eye infections, or dacryocystitis.
Endoscopic DCR is performed through the nose using an endoscope, resulting in no facial scars and faster recovery. External DCR involves an incision on the side of the nose.
No. It is performed under local or general anesthesia, making the procedure itself painless. Postoperative discomfort is usually mild and temporary.
The procedure typically takes between 45 minutes to 1 hour depending on the case complexity.
No. The procedure is performed through the nostril, leaving no external scar on the face.
Most patients recover in 1 to 2 weeks and return to daily activities. Complete healing takes around 4 to 6 weeks.
Yes, a silicone stent may be temporarily placed to keep the new drainage opening open. It is usually removed in 4 to 6 weeks.
Risks include bleeding, infection, re-blockage, stent displacement, and, rarely, damage to nearby structures. Complications are uncommon when performed by an experienced surgeon.
Success rates are high, ranging from 90–95%, especially when performed by a skilled oculoplastic or ENT surgeon.
No. It is usually performed as a day-care procedure, and most patients can go home the same day.
Postoperative care includes saline nasal irrigation, antibiotic eye drops, avoiding nose blowing, and following up for stent removal if placed.
Yes, bilateral DCR can be safely performed in a single session if needed.
The surgery is typically performed by an oculoplastic surgeon, ophthalmologist, or ENT surgeon trained in endoscopic procedures.
Ashu Laser Vision & Ashu Eye Hospital in Andheri, Mumbai, led by Dr. Shahnawaz Kazi, is renowned for safe, advanced, and scar-free Endoscopic DCR surgery.
Laser DCR is a minimally invasive tear duct surgery where a laser is used to create a new drainage passage between the lacrimal sac and nasal cavity to treat tear duct blockages.
Laser DCR uses a focused laser to cut tissue and bone, resulting in less bleeding, quicker surgery, and faster recovery, with no external incision.
Yes. It has a success rate of 80–90%, especially in cases with partial obstruction or early-stage tear duct issues.
The procedure is generally painless and safe. As with any surgery, minor risks include infection, re-blockage, or failure to create a sufficient opening.
Ashu Laser Vision & Ashu Eye Hospital in Andheri, Mumbai, offers advanced Laser DCR surgery under the care of expert surgeon Dr. Shahnawaz Kazi, with excellent outcomes and patient satisfaction.