AIM: To investigate the effect and safety of endoscopic-assisted RS silicone intubation for congenital nasolacrimal duct obstruction after failed probing in children, in order to guide the clinical application.

METHODS: Retrospective case series. Totally 158 children(158 eyes)with congenital nasolacrimal duct obstruction who were failed probing in our hospital from September 2016 to September 2019 were selected as the research subjects. All patients underwent endoscopic-assisted RS silicone intubation. Regular follow-up was performed 1, 3, and 6mo after surgery. Observe the children's gender, age, treatment history, presence or absence of discharge before surgery; treatment effect; complications; types of nasolacrimal duct obstruction. Spearman's correlation coefficient calculation and analysis of the relationship between ages, times of probing and operation efficiency, Fisher's exact probability test for the operation efficiency of different types of nasolacrimal duct obstruction, and chi square test for the operation efficiency of presence or absence of discharge.

RESULTS: The total effective rate was 89.9%(142/158). The effective rate of surgery tends to decrease with age(Spearman's correlation coefficient r_s= -1.000, P<0.01). The effective rate of surgery showed a downward trend with the increase of the times of probing(Spearman's correlation coefficient r_s= -1.000, P<0.01). The efficiency of membranous nasolacrimal duct obstruction surgery is higher than that of complex nasolacrimal duct obstruction, and the difference is statistically significant(P<0.05). It cannot be considered that there is a statistically significant difference in the effectiveness of the operation between the two symptoms with or without discharge(P>0.05). The main complications were: false passage formation(16 eyes, 10.1%), loss of tube(14 eyes, 8.9%), red eyes and irritated tears(18 eyes, 11.4%), punctums tissue adhesion(3 eyes, 1.9%), punctum granuloma formation(1 eye, 0.6%).

CONCLUSION: Endoscopic-assisted RS silicone intubation has a higher effective rate and better safety in the treatment of congenital nasolacrimal duct obstruction after failed probing in children. The effective rate of surgery decreases with age, and decreases with the increase of the times of probing. Membranous nasolacrimal duct obstruction is more effective than complicated nasolacrimal duct obstruction.