BACKGROUND The surgical management of epiphora due to Primary Acquired Nasolacrimal Duct Obstruction (PANDO) is Dacryocystorhinostomy (DCR). Endonasal DCR is becoming more popular than external DCR because of many advantages like avoidance of facial scar, reduced morbidity, lesser time consumption and ease of revision surgery. The aim of the study is to find out the success rate, complications, advantages and disadvantages of endoscopic DCR with and without silastic tube insertion. MATERIALS AND METHODS We performed a clinical prospective comparative study of 70 patients with diagnosis of epiphora due to PANDO in the ENT and Ophthalmology Department of Government Medical College Hospital, Thrissur, from July 2008 to July 2014. Selection of type of operation was left to the patient's choice. A total of 50 patients were enrolled in the Endo DCR group and 20 patients were enrolled in the silastic tube insertion group. RESULTS All the 20 patients who were subjected to Endo DCR with silastic tube achieved anatomical and functional success (100%). In the Endo DCR without silastic tube group, 42 out of 50 patients (84%) achieved anatomical and functional success. CONCLUSION With the introduction of silastic tube, the success rate has increased. It is more useful in patients with less compliance and previous failures.
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