Which Tear-Duct surgery works better? a Head-to-Head test

This trial compares two operations for primary acquired nasolacrimal duct obstruction, a condition where tears cannot drain normally from the eye into the nose, causing persistent tearing. One surgery uses a small skin incision near the inner corner of the eye, while the other goes through the nose with an endoscope and powered tools. Both procedures apply mitomycin C during surgery to reduce scarring. The study follows 60 participants for 12 months to see which approach keeps the new tear drainage opening clear and better relieves tearing symptoms.