OBJECTIVE： To observe clinical efficacy and safety of Tobramycin dexamethasone ointment in Nd： YAG laser lacrimal duct plasty. METHODS： Medical records of 1 000 patients （1 250 eyes） with obstructive lacrimal duct disease receiving Tobramycin dexamethasone ointment in Nd： YAG laser lacrimal duct plasty were selected from our hospital during Jan. 2013-Jan. 2017. They were divided into chronic dacryocystitis group （380 eyes）， small tears （total） tube obstruction group （360 eyes）， nasolacrimal duct obstruction group （342 eyes）， punctal occlusion group （86 eyes） and traumatic canalicular laceration group （82 eyes） according to the lacrimal duct obstruction. In 5 groups， heated Tobramycin and dexamethasone ophthalmic ointment would be loaded in 1 mL syringe and injected into the lacrimal duct via probe， dropping the probe while pushing the ointment. They received lacrimal duct flushing regularly and were followed up for 3 months. Therapeutic efficacies and safty were compared among 5 groups. RESULTS： Cure rate and response rate of patients with chronic dacryocystitis were 85.00％ and 87.63％； those of patients with lacrimal small （total） obstruction were 87.78％ and 94.45％； those of patients with nasolacrimal duct obstruction were 89.18％ and 95.03％； those of patients with punctal occlusion were 84.88％ and 94.18％. All of above were significantly higher than 42.68％ and 64.63％ of patients with traumatic canalicular laceration， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR among 5 groups （P＞0.05）. CONCLUSIONS： In the treatment of chronic dacryocystitis， small tears （total） tube obstruction， nasolacrimal duct obstruction and punctal occlusion， application of Tobramycin dexamethasone eye ointment in Nd： YAG laser lacrimal duct plasty shows good therapeutic efficacy and has less ADR.