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Abstract
This prospective randomized comparative interventional case series study was conducted in Cairo university hospitals in which 40 patients with primary acquired nasolacrimal duct obstruction was included. The aim of the work was to study the efficacy of scarless dacryocystorhinostomy through inferomedial transconjunctival approach in comparison to traditional external dacryocysto- rhinostomy. Patients were divided into two groups; group A in which 20 patients underwent external dacryocystorhinostomy and group B in which 20 patients operated by transconjunctival approach. Postoperative data collection included patient satisfaction, tear meniscus height, the results of irrigation tests and presence of complications. Both techniques show similar results, however, trans-conjunctival approach is associated with higher rate of intra-operative complications, higher tear meniscus height and less patient satisfaction