Objective: To investigate the effects of lacrimal duct recanalization tube implantation in combination with triamcinolone acetonide injection on the local stress response and both short-term and long-term prognosis in patients with refractory lacrimal duct obstruction. Methods: A total of 120 patients with refractory lacrimal duct obstruction were recruited and divided into two groups according to different treatment methods: the control group, which received conventional lacrimal duct recanalization tube implantation, and the study group, which underwent lacrimal duct recanalization tube implantation combined with triamcinolone acetonide injection, with 60 cases in each group. The total therapeutic effect, efficacy-related indicators, local stress response, incidence of complications, as well as short-term and long-term prognoses were compared between the two groups. Results: The total therapeutic efficacy rate of the study group was 96.67%, which was higher than the 83.33% of the control group (P < 0.05). Patients in the study group exhibited lower Visual Analogue Scale (VAS) scores at 24 hours postoperatively, reduced incidence of local edema, shorter duration of pain, and earlier discharge time than the control group (P < 0.05). Additionally, tear secretion test results were higher in the study group (P < 0.05). At 1 week post-surgery, tear levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and substance P were reduced compared to preoperative levels in both groups (P < 0.05), and the study group was lower than the control group (P < 0.05). Within 30 days postoperatively, the complication rate in the study group was lower than that in the control group (6.67% vs. 21.67%, P < 0.05). 6 months post-operation, the incidence and recurrence rate of related adverse events in the study group were 5.00% and 3.33%, respectively, which did not differ significantly from the control group values of 16.67% and 10.00% (P > 0.05). At 12 months post-operation, the incidence of related adverse events and the recurrence rate in the study group were 11.67% and 8.33%, respectively, both of which were lower than 30.00% and 25.00% in the control group (P < 0.05). Conclusion: The combination of lacrimal duct recanalization tube implantation with triamcinolone acetonide injection demonstrates significant efficacy in alleviating local stress responses, minimizing postoperative complications, and reducing the long-term recurrence risk. This approach represents a safe and efficient therapeutic option for patients suffering from refractory lacrimal duct obstruction.