DCR failure?

I had a DCR surgery about 6 1/2 weeks ago.  At first my eye was wonderfully dry...almost too dry as I have post LASIK dry eye syndrome pretty severe.  Over the next week my eye started to hold in a bit more tears and it was perfect.  Then it continued and now I have watery eye again.  I was totally blocked in right eye to irrigation and probing.  It was thought that my upper and lower plug had migrated and caused my blockage at the common canaliculus area.  After surgery my doctor told me it was scar tissue and he looked all through the lacrimal sac and couldn't find my plugs.  He said they used some spacers(??) to stretch things out and removed the scar tissue.  I had a functioning tear drain for about a week.  It was nice to put in a drop and it actually disappeared.  My doctor said as things heal they tighten up and hopefully it will relax, wait and see.  I seem to have alot of inflammation and pressure still in the surgery area.  Will this heal, relax and open up again?  If not, what are my options?  Does this mean another surgery?  I'd hate to do this again, but the "hot tears" (as my dry eye doc says) cause more pain than severe dry eye.  Thanks for any advice.
Maurie

[JodieJ]

If you still have stents in your eye, that could be the cause of your tearing.  Usually stents are not removed until a few months after surgery.

I think that you will have to wait and see how things turn out.  If your tearing does not resolve, I suggest that you consult 2-3 oculoplastic surgeons for recommendations before proceeding.  In this case, possibilities would include revision DCR (perhaps endoscopic) or CDCR with a Jones tube.  Jones tube surgery frequently involves complications, so be sure that you understand the risks before choosing this option.  Botox injected into the lacrimal gland is another possibility for controlling a teary eye, but I don't know whether your health insurance would pay for this.

[John C Hagan III, MD, FACS, FAAO]

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[MRC5]

I do still have stents in my eye, but I wasn't tearing for the first 5-7 days.  Does this mean I'm not healing right and things have closed up?  Or do some people continue to tear until the stents are removed?  (It's not the dry eye and reflex tearing as drops do not escape now where they did post surgery).

I'm hoping when the stent is removed there will be just the "right" amount of room for tears to escape.  With my severe dry eye, a little blockage for the end result would be nice.  That is how my left eye is.  You can irrigate the lower well and upper partially but can't get past either at the common canaliculus with the probe.  It works great for me.

[JodieJ]

I'm not an eye care professional.  To the best of my knowledge, most people do continue to tear until the stents are removed.  With the stents in place, your tear duct cannot close up, but the stents do take up room.  There are a couple of women who have posted journals about their recovery from DCR surgery--try googling.  (For whatever reason, I'm not able to send you a private message with the links--which can't be posted on this site.)

I really hope your surgery is successful.  Your surgeon is your best source of information.