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.
- Excessive uncontrollable bleeding may require abandoning the operation and reattempting it at a later date.
- Damage to the medial rectus and superior oblique may cause diplopia.
- Blindness may occur from damage to the intraorbital vessels or optic nerve.
- Cerebrospinal fluid leak due to penetration of the cribriform plate
- Injury to the orbital contents from rongeurs or drill
- Injury to the canaliculi from improper probing
- Shredding of the lateral nasal mucosa due to improper bone removal
- Sump syndrome may occur if the rhinostoma is small and high up in the lacrimal sac. This causes tears and mucus to accumulate in the sac and discharge into the eye.
- Ocular-orbital lesions, especially from orbital fat exposure
- Persistent watering may indicate scarring of the rhinostoma and may require reoperation.
- Orbital hematoma (eye swelling with blood)
- Subcutaneous emphysema
- Canalicular laceration
- Cerebrospinal fluid leakage (leading to greater risk of infection, such as meningitis)
- Air regurgitation through puncta, especially when sneezing and when talking
- Disturbing altered sensation in eye
- Dry eye
- Persistent pain at surgical site, even after healing
- Swelling and bruising
- Excessive tearing
- Facial scarring (in external DCR)
- Complete failure/additional surgeries
Complications associated with silicon intubation as part of DCR
- Pyogenic granulomata may occur at the puncta or the site of rhinostomy if the tubing is left in too long.
- Retrograde migration and corneal irritation
- Soft tissue infection
- Retained silicon tube and DCR failure
- Adhesions, elongation, slitting or erosion of the puncta
- Nasal migration
- Traumatic injury to the nasal septum