DCR surgery should never be the first line of defense in epiphora treatment. In fact, it should never be the second or third, either. It should be dead last in the list. Only when every other method has been utilized exhaustively should such a drastic procedure be considered, and only then after the patient has been fully informed about the how a DCR is performed and what the risks are. Sparing details here is no different from flat-out lying. A lie by omission is still a lie. Lying to patients about the details of a medical procedure is about as unethical as it gets.
This is an open letter I worked on with another dry eye sufferer. It speaks from our own experiences as well as the stories of countless others we’ve communicated with and have read about. The letter is on behalf of every dry eye patient in Australia. In it, we outline the problems with Australian protocols for dry eye—namely that they are outdated and far behind the practices in the US and much of Europe. We then outline a number of treatment options unavailable in Australia that are either established or emerging in other countries across the globe.
This letter has been sent to every eye specialist in Australia. We hope that it will help to bring attention to our plight, and foster change in the Australian medical community regarding the treatment of dry eye.
This is a fairly complete list of the risks and complications associated with DCR surgery for block tear ducts. Some of these are specific to external DCR and others are specific to the endoscopic variety, but in general they all apply to both varieties. If you aren’t willing to accept that these complications could occur, then you probably should not have the procedure done. While some of these complications are rare, they are all very possible and well-documented.
(Please see my original post on DCR alternatives if you haven’t already.)
Here is a list of some additional studies supporting alternative or at least precursors to DCR surgery. This is by no means a complete collection of relevant studies, but it’s a solid foundation for your further research. One of the most common lines you’ll hear from a doctor looking to write off something he or she is ignorant of is this: ‘You can’t base your practices on a single study.’ Yes, this is true. A single study doesn’t prove much. But we’re not looking at a single study. When this list was originally complied (2007), there were already dozens and dozens of studies. As of this writing, fives years later, there are even more. The research is solid. Doctors can’t keep on ignoring the facts.