In a series of 50 consecutive cases, a modification of the Kasper technique of dacryocystorhinostomy without flaps resulted in a success rate of 90%. The success rate was 92.5% in patients with nasolacrimal duct obstruction alone, but only 80% in those with both nasolacrimal duct obstruction and canalicular disease. The results of this study indicate that equivalent results are achieved with or without the use of flaps. The elimination of flaps shortens and simplifies the procedure.