To investigate the efficacy of endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent in the treatment of extremely inferior lacrimal duct obstruction.Retrospective cohort study at Nanchang University's Affiliated Eye Hospital. Experimental Group: Endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent implantation; Control group: Conventional endoscopic dacryocystorhinostomy combined with bicanalicular Silicone Stent implantation.The duration of the surgical procedure, postoperative comfort score, irrigation of the lacrimal passage after extubation, and Munk score of curative effect at six months post-operation were recorded. The data were quantified and analyzed using SPSS 26.0 statistical software. The symptoms of epiphora showed significant improvement following surgery. There were notable differences in operation time and postoperative comfort between the experimental group and the control group who underwent conventional endoscopic dacryocystorhinostomy (P < 0.05). However, there was no significant difference in efficacy and lacrimal duct irrigation after extubation or at six months post-operation (P > 0.05). The cure rate of the experimental group reached 70%, while the control group achieved a cure rate of 78%. Furthermore, the effective rate in the experimental group was found to be 81%, whereas it was 89% in the control group.No evident complications were observed in the experimental group. The combination of endoscopic membranous nasolacrimal duct resection and retrograde lacrimal stent reduces the invasiveness of the lacrimal duct structure, shortens the operation time, improves patient comfort, and achieves favorable therapeutic outcomes. This approach is recommended for patients with extremely Inferior lacrimal duct obstruction .
