Introduction & Objective: Epiphora is one of the most common problems in the primary adult nasolacrimal duct obstruction (PANDO) . The surgical treatment of epiphora is dacryocystorhinostomy(DCR) which is performed in two methods : External and Endonasal.

Materials & Methods : In this prospective randomized clinical trial study, results and complications of these two methods were compared in Emam Khomeiny Hospital of Hamadan University of Medical Sciences during 2001-2002 . Total cases of PANDO were 50 which was divided in two groups randomly. After surgery all patients were followed for 6 to 12 months .

Results : In 92% of both groups, epiphora were resolved clinlcally, but in 16% of external and 8% of endonasal groups obstruction was seen in irrigation test (P>0.05). In the first week after surgery, all patients of endonasal group and 76% of external group were pain free. Nasal discharge in endoscopic group was significantly higher than external group.

Conclusion: In conclusion although the results of these two methods were similar, external DCR remains the procedure of choice in treatment of NLD obstruction.