AIM: To compare the medical effects and economic benefits between spherical headed silicone intubation(SHSI)and endoscopic dacryocystorhinostomy(En-DCR), to further verify the therapeutic effect of modified SHSI under endoscope on NLDO.

METHODS: The 43 patients with 50 eyes of NLDO were randomly divided into SHSI group(21 cases and 25 eyes)and En-DCR group(22 cases and 25 eyes). Then to compared the intraoperative bleeding volume, monocularoperation time, surgical discomforta, nd hospitalization time between the two groups of patients. Followed-up to 12mo after surgery, the clinical efficacy was evaluated according to the situation of tear overflow and lacrimal lavage at the last follow-up, and the cost-effectiveness ratio(C/E)was used to evaluate the economic benefits.

RESULTS: The intraoperative blood loss and surgical discomfort visual analogue scores of patients in the SHSI group were significantly lower than those in the En-DCR group(4.96±1.989mL vs 27.60±14.950mL, 2.84±0.64 vs 4.88±0.84). Monocular surgery time and hospital stay were significantly shorter than those in the En-DCR group(13.40±6.007min vs 59.64±12.786min, 0.50±0.010h vs 137.280±23.085h)(All P<0.001). At the last follow-up, the clinical effectiveness rate of the two groups was no difference(88% vs 96%, P>0.05), but the C/E(13.57)of patients in SHSI group was far smaller than that of En-DCR(121.50).

CONCLUSION: Endoscopic SHSI and En-DCR are both effective surgical methods for nldo. But SHSI surgery is relatively lower difficult and has significant cost-effective advantages.