Background Congenital nasolacrimal duct obstruction (CNLDO) is a common cause of epiphora in children. Lacrimal intubation is often performed when probing fails, but the optimal approach remains debated. This study compared the outcomes of nasal endoscopy–guided and blind closed lacrimal intubation in pediatric patients with CNLDO. Methods This prospective comparative study (single‐center retrospectively registered) was conducted on 63 eyes of 39 children under 16 years. Participants were randomly assigned to blind closed intubation ( n = 31) or nasal endoscopy–guided intubation ( n = 32). Outcomes included operative time, epiphora score, fluorescein dye disappearance test (FDDT), complications, and patient satisfaction. Results Operation time was significantly lower in the nasal endoscopy–guided group than that in the closed group ( p < 0.001). Epiphora score, FDDT, postoperative complications, and satisfaction were comparable. Cut tube occurred in 3.23% of the blind group versus 3.45% of the nasal endoscopy–guided group, while cheese‐wiring and persistent tube were observed in 3.23% and 6.9% of the blind cases compared with 6.9% and 6.9% of the nasal endoscopy–guided cases, respectively. Prominent tube and postoperative lacrimation were noted only in the nasal endoscopy–guided group (13.79% and 6.9%), whereas dacryocystitis and recurrence were confined to the blind group (6.45% and 12.9%). Regarding satisfaction, high satisfaction was reported in 70.97% of the blind group versus 59.38% of the nasal endoscopy–guided group, moderate satisfaction in 12.9% versus 31.25%, and no satisfaction in 16.13% versus 9.38%, respectively. Conclusions Both blind and endoscopic lacrimal intubation achieved high success rates in children with CNLDO. The nasal endoscopy‐guided technique shortened operative time and offered better visualization, but overall outcomes and satisfaction were comparable. Trial Registration: Pan African Clinical Trials Registry (PACTR): PACTR202510699342440
Rashdan et al. (Thu,) studied this question.