We were interested to read the above article 1 on non‐laser dacryocystorhinostomy (DCR) and delighted to view the high quality endoscopic colour pictures provided to illustrate the paper. Although we have used the Holmium:YAG laser in our endoscopic ‘inferior’ DCR series, 2 we have to point out that there is now little doubt that the external approach to DCR remains the gold standard in terms of optimal long‐term fistula patency. 3 We have recently presented work to the Otolaryngological Research Society which adds further weight to this opinion. 4 There are now many papers presenting case series of laser‐ and non‐laser DCRs, all claiming that theirs is the method of choice. 3 There is evidence of long‐term fistula failure which is greater following endoscopic procedures 2,5 and we would be interested to see the results of objective assessments of patients in the Ipswich series after a longer‐term follow‐up period. What is really required is a prospective randomised controlled trial to compare non‐laser with Holmium:laser (the optimal laser for the procedure 3) endoscopic DCR before anyone can truly claim which method gives the most superior long‐term results.