The secondary end point will be anatomical success, as measured by patency of nasolacrimal irrigation at 6 months post-operatively. In patients with tubes these will be removed at 3 months post-operatively. The operation will be considered successful if there is free flow on irrigation with no reflux. It will be considered partially successful if the nasolacrimal duct is patent but there is more than 50% reflux as assessed by an experienced oculoplastic surgeon. It will be considered a failure if there is more than 50% reflux.