白内障超声乳化摘除联合小梁切除术以及单纯小梁切除术在原发性闭角型青光眼的治疗中的对比研究

白内障超声乳化摘除联合小梁切除术以及单纯小梁切除术在 原发性闭角型青光眼的治疗中的对比研究 背景：对于原发性闭角型青光眼的眼压控制来说,小梁切除术是主流手术方式,而对合并有白内障的原发性闭角型青光眼患者,小梁切除联合白内障超声乳化摘除+人工晶体植入术不仅可以控制眼压,还可以提高患者的视力。本文旨在对两种手术方式在合并白内障的原发性闭角型青光眼的安全性和有效性进行对比研究。 方法：本文为病例对照系列研究。共纳入31例合并白内障的原发性闭角型青光眼患者,其中,17例患者行小梁切除术联合白内障超声乳化摘除+人工晶体植入术,14名患者单行小梁切除术。对于术后的眼压、滤过泡及并发症进行对比。手术完全成功定义为术后不用降眼压药物时眼压低于21mmHg. 结果：术后共随访10个月,青白联合及单纯小梁切除组在降眼压方面没有显著差异(20.597.94 vs. 24.8514.39 mmHg, P=0.614),完全成功率分别为88.2% 及 71.4%, （P=0.37）,滤过泡形成比例分别为64.7% [11/17] vs. 92.9% [13/14]（P=0.094）,并发症发生的比例分别为41.2% [7/17] vs. 57.1% [8/14],（P=0.38）。两组患者中绝大多数术后停用降眼压药物;单纯行小梁切除组部分患者需要进一步的手术干预,包括前房形成术、白内障超声乳化术等。 结论：虽然单纯小梁切除术组术后有几例因白内障及并发症的存在需进一步手术,青光眼白内障联合术及小梁切除术在合并白内障的原发性闭角型青光眼的降眼压效果、手术成功率及术后并发症相当。 关键词：原发性闭角型青光眼;小梁切除术;白内障超声乳化摘除联合梁切除术;白内障。     

小梁切除术联合超声乳化术在原发性闭角型青光眼与原发性开角型青光眼合并白内障中的疗效比较

目的比较小梁切除术联合超声乳化术治疗原发性闭角型青光眼（primary angle closure glaucoma,PACG）与原发性开角型青光眼（primary open angleg laucoma,POAG）合并白内障的眼压控制情况及并发症。方法回顾性收集在我院近年行小梁切除术联合超声乳化术的PACG与POAG的患者资料,对患者手术前后眼压、最佳矫正视力、手术并发症等指标进行观察并进行比较。完全成功率标准为手术后最终随访时不用任何降眼压药物,眼压控制在≤21mmHg。结果本研究共有17例（17只眼）PACG与14例（14只眼）POAG。PACG组与POAG组间的年龄、术前眼压、随访时间均无统计学差异。PACG组与POAG组在分别经过11.4个月与13.2个月的手术后随访后,2组的眼压均下降,PACG的最后随访眼压（10.1±4.5）mmHg低于POAG组（15.8±8.3）mmHg（P=0.025）。最后随访时,PACG组的完全成功率为100%高于POAG组（78.6%）（P〈0.05）。58.8%的PACG患者与57.1%的POAG患者术后视力得到提高。2组的并发症均较轻。结论小梁切除术联合超声乳化术能够安全、有效控制PACG与POAG合并白内障的眼压,PACG的眼压控制优于POAG。     

两种术式治疗闭角型青光眼合并白内障的比较

目的比较青光眼白内障联合手术与单纯小梁切除术治疗青光眼合并白内障的临床疗效。方法选择2009年1月～2011年12月四川省南充市中心医院眼科收治的青光眼合并白内障患者128例（128眼）,分为A组（青白联合手术组,n=52）和B组（单纯小梁切除术组,n=76）。术后随访6个月,观察治愈率、眼压、术后视力、术后并发症等情况。结果术后6个月,A组患者治愈率为90．4％,B组患者治愈率为86．8％．两组治愈率比较,差异无统计学意义（P〉0．05）。两组术后眼压分别较术前均有明显下降,差异均有高度统计学意义（均P〈0．01）,但两组间术后眼压差异无统计学意义（P〉0．05）。A组术后视力较术前有明显好转,差异有高度统计学意义（P〈0．01）;B组术后视力与术前比较,差异无统计学意义（P〉0．05）;两组间术后视力比较,A组优于B组,差异有统计学意义（P〈0．05）。A组术后并发症发生率为[19．2％（10／52）1,与B组[14．5％（11／76）1比较,差异无统计学意义（P〉0．05）。结论对于有白内障手术指征的青光眼患者,选择青白联合手术治疗青光眼合并白内障手术安全、临床效果显著,而且术后视力恢复快,提高了患者的生活质量。     

小梁切除术联合超声乳化治疗原发性闭角型青光眼的效果观察

目的比较超声乳化联合小梁切除术和单纯小梁切除术在治疗原发性闭角型青光眼合并白内障中的疗效和安全性。方法31例（31只眼）原发性闭角型青光眼伴有白内障患者,其中17例（17只眼）接受小梁切除术联合超声乳化治疗,14例（14只眼）接受小梁切除术治疗。在术后随访过程中分别记录并比较两组患者眼压、滤过泡和并发症等状况。结果术后随访10个月,发现超声乳化小梁切除术组和小梁切除术组在眼内压降低值[（20．59±7．94）mmHgV8（24．85±14．39）mmHg,P=0．614）]、治愈率（88．24％VS71．43％,尸卸．370）、功能性小泡形成率[76．47％（13／17）vs78．57％（11／14）,P=0．094]和并发症发生率【（47．06％（8／17）VS．50．00％（7／14）,P=0．380）】方面差异无统计学意义。两组中大多数患者不能用降低眼内压的药物。在小梁切除术组需要额外的手术干预,包括对眼前房的改善和超声乳化白内障法。结论即使在小梁切除术后的白内障和并发症患者中,在某些情况下可能需要额外的手术干预,但在治疗原发性闭角型青光眼和白内障并发性患者时,超声乳化小梁切除术和小梁切除术显示出类似的眼内压降低值、成功率和并发症。     

颞侧反眉状隧道小切口在抗青光眼术后白内障术中的应用

目的:探讨颞侧反眉状隧道小切口非超声乳化在抗青光眼术后白内障囊外摘除术联合人工晶状体植入术的疗效。方法:对抗青光眼小梁切除术后57例(65眼)白内障患者,采用颞侧反眉状隧道小切口非超声乳化行白内障囊外摘除联合人工晶状体植入术,观察术后视力、并发症、眼压、滤过泡等进行分析。结果:术后7d视力(含矫正视力)小于0.3者11眼(16.92%),0.3～0.5者43眼(66.15%),0.5以上者11眼(16.92%);在并发症中,发生角膜水肿13眼(20.00%),虹膜损伤14眼(21.54%),后囊破裂3眼(4.62%);所有病例眼压均控制在正常范围,滤过泡均能有效保留。结论:颞侧反眉状隧道小切口白内障囊外摘除术联合人工晶状体植入术是治疗抗青光眼小梁切除术后白内障患者的有效方法。     

Efficacy and tolerability of one-site versus two-site phaco- trabeculectomy: a meta-analysis of randomized controlled clinical trials

Background Phacotrabeculectomy can be performed using one-site or two-site incisions.This meta-analysis evaluated the efficacy and tolerability of one-site versus two-site phacotrabecuiectomy in the treatment of patients with coexisting cataract and glaucoma.Methods A comprehensive literature search was performed according to the Cochrane Collaboration methodology toidentify randomized controlled clinical trials comparing one-site with two-site phacotrabeculectomy.Studies meeting our predefined criteria were included in the meta-analysis.Efficacy estimates were measured by weighted mean difference （WMD） for the percentage intraocular pressure （IOP） reduction from baseline to end point, relative risk （RR） for the proportion of patients with a best-corrected visual acuity （BCVA） of 0.5 or better after surgery and complete success rates.Tolerability estimates were measured by RR for adverse events.All of outcomes were reported with 95% confidence interval （95% CI）.Data were synthesised by Stata 10.1 for Windows.Results Two-site phacotrabeculectomy was associated with greater reductions in IOP than the one-site procedure （WMD： -5.99, 95% CI： -10.74-1.24, P=0.01）.A greater proportion of patients also achieved a BCVA of 0.5 or better （RR：0.91, 95% CI： 0.74-1.12, P=0.36） and the target IOP without anti-glaucoma medication at the study end point （RR： 0.94,95% CI： 0.83-1.07, P=0.34） after two-site than one-site phacotrabeculectomy, but the differences were not significant.There were no significant differences in adverse events between two surgical procedures.Conclusions Two-site phacotrabeculectomy is superior to one-site phacotrabeculectomy in reducing IOP, but other post-operative effects are similar.One-site and two-site phacotrabeculectomies have similar adverse event rates.     

连续回顾性研究对比粘小管切开术和小梁切除术治疗先天性青光眼的疗效

Background Surgical interventions are the main treatment for primary congenital glaucoma (PCG).This study aimed to compare the efficacy and safety between viscocanalostomy and mitomycin C (MMC)-trabecu...     

双切口联合术治疗青光眼合并白内障

目的探讨双切口复合式小梁切除术联合白内障超声乳化及人工晶状体植入术（双切口联合术）治疗青光眼合并白内障的临床疗效。方法回顾分析42例48只青光眼合并白内障患者,这些患者均施行双切口联合术,观察术前和术后视力、眼压、滤过泡形成及并发症,术后随访6～12个月。结果术后所有患眼视力均有不同程度提高,手术前后视力比较差异具有统计学意义（χ2=17.42,P〈0.05）。眼压由术前（23.4±2.6）mmHg,降至术后最末次随访（14.3±3.1）mmHg,平均下降（8.9±4.5）mmHg,手术前后眼压比较差异具有统计学意义（t=4.915,P〈0.05）。Ⅰ型滤过泡11只眼（22.9%）,Ⅱ型滤过泡24只眼（50.0%）,功能型滤过泡形成率为72.9%。术后主要并发症为早期轻度角膜水肿和前房内炎症渗出反应及一过性高眼压,无术中、术后严重并发症发生。结论双切口联合术能有效控制眼压,提高视力,缩短疗程,是治疗青光眼合并白内障简捷、安全、有效的方法。     

M形切口白内障摘除联合小梁切除术治疗青光眼合并白内障的疗效观察

目的评价M形切口白内障摘除人工晶体植入联合小梁切除术(三联手术)治疗青光眼合并白内障的安全性及有效性,并比较M形和超声乳化两种切口三联手术的临床疗效。方法按不同术式将40例(43只眼)拟行白内障摘除人工晶体植入联合小梁切除手术的患者,分为M形切口组25只眼和超声乳化组18只眼。术后随访15～37个月。结果术前平均眼压M组(25.3±9.8)mmHg,超声乳化组(25.7±9.5)mmHg,术后随访最终平均眼压M组(15.53±5.3)mmHg,超声乳化组(15.01±3.2)mmHg。术后随访最终矫正视力范围0.1～1.2,2组≥0.5者分别为15只眼(60%)及12只眼(66%),术后平均散光度M组(0.89±0.31)D,超声乳化组(0.78±0.5)D。2组术后平均眼压下降、视力及散光度数均无显著性差异(P>0.05)。结论M形小切口与超声乳化三联手术治疗青光眼合并白内障,均具有恢复有用视力、较好的降低眼压、并发症少等作用,2种术式结果则基本相同。     

Effectiveness of combination of permanent and releasable scleral flap sutures in trabeculectomy: A randomized clinical trial

Introduction: Trabeculectomy is a commonly used surgical treatment for glaucoma. Purpose: To evaluate the effectiveness of combination of permanent and releasable scleral flap sutures to minimize the immediate postoperative complications of trabeculectomy. Materials and methods: This study was carried out in Department of Ophthalmology, B P Koirala Institute of Health Sciences, Dharan, Nepal. Forty one eyes of 34 patients undergoing trabeculectomy were randomized to undergo either conventional trabeculectomy (Group A= 20 eyes) or trabeculectomy with combination of permanent and releasable scleral flap sutures (Group B =21 eyes). The parameters studied were intraocular pressure (IOP), anterior chamber depth (ACD) and surgical complications over a period of 6 weeks. Results: Significantly higher number of eyes belonging to group A (14 eyes) had shallower anterior chamber than group B (7 eyes) on first post operative day (p=0.042). Six eyes (30%) in group A had peripheral or central irido-corneal touch in early postoperative period as compared to only one in Group B. Hypotony was noted in 3 eyes in each group. Two patients in group A required reformation of anterior chamber. Other surgical complications in the two groups were similar. Both the groups had a significant drop in IOP following surgery. However, there was no significant difference in the IOP between the two groups after 6 weeks (Group A: 10.95 +/- 3.03 mmHg vs. Group B: 12.29 +/- 4.67 mmHg; p=0.87). There was a significant drop in IOP following removal of sutures (15.19 +/- 6.15 mmHg to 13.19 +/- 6.13 mmHg; p=006) in group B. Conclusion: Use of combination of permanent and releasable scleral flap sutures is a safe technique that significantly reduces the incidence of immediate postoperative shallow anterior chamber after trabeculectomy. Key words: Trabeculectomy, Intra ocular pressure, anterior chamber depth, combination of releasable and permanent scleral flap sutures.     

羊膜移植及丝裂霉素C联合可拆除缝线小梁切除术治疗难治性青光眼

目的探讨羊膜移植及丝裂霉素C（MMC）联合可拆除缝线小梁切除术治疗难治性青光眼的效果。方法8例（10眼）难治性青光眼均采用瑞济冷冻干燥羊膜移植联合可拆除缝线小梁切除术，术中于巩膜瓣和结膜瓣下放置0．3mg／mLMMC2min.术后1周、1月及1年，检查记录术眼眼压、滤过泡、前房深度情况。结果术后1周无浅前房出现，术后早期持续性低眼压1例，术后1年除1眼眼压23．78mmHg需用药物控制外，其余9眼眼压在7～18mmHg之间，均保持功能性滤过泡及良好的前房深度。结论羊膜移植及MMC联合可拆除缝线小梁切除术可减少滤过道疤痕的形成，有效控制术后滤过水平，减少术后并发症发生。     

四联手术治疗难治性青光眼合并白内障疗效分析

目的 评价白内障超声乳化摘除折叠式人工晶状体（intraocular lens,IOL）植入联合小梁切除及青光眼引流器植入术（四联手术）治疗难治性青光眼合并白内障患者的安全性、有效性.方法 采用上方3.5mm常规巩膜切口对56例（68眼）白内障合并房角关闭患者行四联手术,并分别于术后1、3、6、12、24个月进行随访,观察所有患者眼压、滤过泡、房角、视力的变化情况.结果 随访期间各时点眼压均较术前显著降低,差异均有统计学意义（均P＜0.01）.术后24个月时形成Ⅰ、Ⅱ型滤过泡59眼（86.76%）,Ⅲ、Ⅳ型滤过泡9眼（13.24%）.术后房角粘连明显改善（P＜0.05）,≤90°者46眼（67.6%）.术后12、24个月患者矫正视力≥0.5者分别为45眼（66.2%）及52眼（76.5%）,均显著优于术前（P＜0.01）.结论 四联手术是治疗难治性青光眼合并白内障的一种有效、便捷、可重复和安全的联合手术,不仅能提高患者视力而且能有效地降低眼压,延长滤过泡功能,减少瘢痕形成,提高滤过性手术的成功率.     

Phacotrabeculectomy Versus Conventional Combined Technique in Coexisting Glaucoma and Cataract

Background

To evaluate and compare efficacy and outcome after single site phacotrabeculectomy and conventional combined surgery in cases of coexisting primary open angle glaucoma and cataract.

Methods

This prospective study on fifty patients of concurrent primary open angle glaucoma and cataract, who had undergone combined surgery as single site phacotrabeculectomy or conventional single site trabeculectomy with extracapsular lens extraction with IOL implantation in 25 cases each. Evaluation was based on operative and postoperative complications, control of IOP and visual outcome. The follow up period ranged between twelve months to eighteen months.

Results

The mean medically controlled preoperative intraocular pressure was 22 mm of Hg (Range 18 to 35 mm of Hg) by applanation method of tonometry. The range of postoperative intra-ocular pressure after one year was 11 to 22 mm of Hg in first and 14 to 26 mm Hg in second group. Failure to maintain optimum postoperative IOP without Beta-blocker was more frequent after conventional combined procedure. There was no significant difference in incidence and pattern of postoperative complications.

Conclusion

Phacotrabeculectomy provides effective and sustained visual recovery and adequate control of intraocular pressure as compare to conventional combined procedure.Key Words: Phacotrabeculectomy, Comparison with conventional combined procedure     

超声乳化术治疗膨胀期白内障继发青光眼34例

目的评价透明角膜切口超声乳化白内障吸除联合人工晶体植入术,治疗膨胀期白内障继发青光眼的临床疗效。方法回顾分析34例（41眼）膨胀期白内障继发青光眼患者临床资料,其中用药后眼压控制良好择期手术34眼、高眼压条件下急诊手术7眼,均采用透明角膜切口白内障超声乳化联合后房折叠型人工晶体植入术。术后随访2个月-3年,对比术前术后视力、眼压、前房深度和房角开放范围。结果术中、术后所有患者均未发生严重手术并发症。术后最佳矫正视力明显好于术前（P〈0．01）;眼压比入院接诊时明显下降（P〈0．001）;前房深度加深,术前术后差异有统计学意义（P〈0．001）。41眼中有2眼术后半年加用抗青光眼药物。所有患者原狭窄房角增宽,关闭的房角部分开放。结论白内障超声乳化摘除联合人工晶体植入术是治疗膨胀期白内障继发青光眼的一种有效手段。     

复合小梁切除联合房角分离术治疗急性闭角型青光眼

目的 探讨复合小梁切除联合房角分离术治疗急性闭角型青光眼疗效.方法 急性闭角型青光眼患者52例56眼,用2%毛果芸香碱眼液治疗后眼压可降低至正常范围内,一周后行复合小梁切除联合房角分离术,观察术后3个月时的前房及房角情况、视力﹑眼压﹑并发症.结果 术后3个月与术前比较,52例56眼中38眼视力提高,14眼视力不变,4眼视力下降;术后3月时平均眼压（14.76±3.42）mmHg,与术前眼压（54.65±9.88）mmHg比较差异有统计学意义（t=27.12,P＜0.001）,术中术后均未出现严重并发症;所有术眼术后一周前房明显较术前加深,术后3月时UBM复查前房深度,与术前相比较差异无统计学意义（t=0.538,P＞0.5）;房角情况：术前48眼房角全部粘连闭合,8眼房角闭合3/4周,术毕时间接房角镜下检查56眼前房角均360°开放,术后3月房角复查17眼房角粘闭＞1/2周,34眼房角粘闭≤1/2周,5眼房角开放.结论复合小梁切除联合房角分离术治疗急性闭角型青光眼安全有效     

Long-term intraocular pressure fluctuation of primary angle closure disease following laser peripheral iridotomy/iridoplasty

Background  Many studies indicated that short-term and long-term intraocular pressure (IOP) fluctuations in primary open angle glaucoma patients might lead to glaucomatous progression. However, seldom study has evaluated the long-term fluctuation of IOP in primary chronic angle closure diseases. The objective of this study was to investigate the long-term IOP fluctuation of primary angle closure diseases and its associations following laser peripheral iridotomy (LPI) with or without laser peripheral iridoplasty.

Methods  A total of 158 patients with primary angle closure suspect (PACS, n=21), primary angle closure (PAC, n=81) and primary angle closure glaucoma (PACG, n=55) had been treated by LPI with or without laser peripheral iridoplasty and followed up for more than 12 months. IOP was measured with Goldman applanation tonometer. Multivariate linear regression with generalized estimating equation (GEE) regression models was used to evaluate the association of long-term IOP fluctuation (maximum IOP minus minimum IOP) with gender, age, baseline IOP, baseline peripheral anterior synechia (PAS), baseline vertical cup/disc ratio (VCDR), baseline mean deviation (MD), need for IOP-lowering medications.

Results  IOP fluctuation during follow-up in PACS, PAC and PACG groups were (4.83±2.90), (5.67±3.35), and (9.40±7.14) mmHg, respectively. IOP fluctuation was strongly correlated with baseline IOP (r=0.356, P <0.001), PAS (r=0.374, P <0.001). IOP fluctuation was higher in patients with higher baseline IOP (0.18 mmHg per unit increase, 95% CI: 0.05–0.31 mmHg).

Conclusions  Long-term IOP fluctuation in PACG group was larger than that in PACS or PAC group. Eyes with higher baseline IOP were observed to have larger long-term IOP fluctuation.

     

双切口白内障超声乳化术联合青光眼小梁切除术的有效性和安全性

目的：观察青光眼合并白内障患者采用双切口白内障超声乳化摘除术和人工晶状体植入术联合青光眼小梁切除术(双切口三联术)治疗的有效性和安全性。方法选取我院2013年1月至2015年6月期间收治的青光眼合并白内障患者62例(80眼),按随机数表法分为两组,观察组31例（40眼）予以双切口三联术治疗;对照组31例(40眼)予以单切口三联术治疗,比较两组患者术前、术后1个月、术后6个月的视力、眼压、术后过滤泡、散光以及术后并发症发生情况。结果两组患者术后1个月和6个月的视力和眼压均较术前明显改善,差异均有统计学意义(P<0.05),但组内比较差异均无统计学意义(P>0.05);两组患者术后1个月和6个月的功能滤过泡眼数相当,差异均无统计学意义(P>0.05);术后1个月,对照组患者散光较观察组增大(P<0.05),术后6个月,两组散光比较差异无统计学意义(P>0.05);观察组术后合并症发生率为17.50%(7/40),与对照组的20.00%相当(8/40),差异无统计学意义(P<0.05)。结论对于青光眼合并白内障患者,给予双切口白内障超声乳化摘除术和人工晶状体植入术联合青光眼小梁切除术治疗与单切口术式治疗疗效相当,其具有手术操作简单和术后并发症少的优点,值得临床推广应用。     

Trabeculectomy--a review and 2 year follow up

This study reviewed the trabeculectomies (TEs) carried out in University Malaya Medical Center between 1994 to 1998. One hundred and nine of 132 eyes operated were in the primary glaucoma group of which 63 (47.7%) were of the open angle type and 46 (34.8%) were of the angle closure type. Twenty-three eyes belong to the secondary glaucoma group. Sixty-five eyes had plain or non-augmented trabeculectomy (TE) while 20 were augmented with mitomycin C (MMC) and 11 with 5 flourouracil (5FU). In 31 eyes the plain TEs were combined with extracapsular cataract extraction (ECCE) and 4 with phacoemusification. One case had combined ECCE and augmented trabeculectomy with mitomycin-C. The patients were followed up at 1 month, 6 months, 1 year and 2 years. Ninety-four of 132 (71.2%) eyes had successful surgery with intraocular pressure (IOP) of less than 21 mmHg (tonometric success) at the end of 2 years. Four of these patients needed topical medication for the IOP control. More failures were seen in patients with cystic blebs than those with diffuse blebs. Complications include hypotony, shallow anterior chamber, cataracts and hyphaema. The majority of cases (53%) had no complications.     

Ahmed青光眼引流阀植入联合1.8 mm微切口白内障超声乳化术治疗合并白内障的难治性青光眼

目的 观察Ahmed青光眼引流阀植入联合1.8 mm微切口白内障超声乳化手术治疗合并白内障的难治性青光眼的疗效及安全性。方法 对21例接受Ahmed青光眼引流阀植入联合1.8 mm微切口白内障超声乳化手术的合并白内障的难治性青光眼患者进行回顾性分析,总结术前术后眼压,最佳矫正视力,角膜散光变化及术中、术后并发症的发生情况。结果 所有患者的平均随访时间为11.7个月(8～21个月)。所有患者术后眼压较术前均有不同程度下降,术前平均眼压为(37.9 ±10.2)mmHg,末次随访时平均眼压为(14.3 ±5.8)mmHg(t=9.19,P＜0.01)。2例患者术后仍需使用抗青光眼药物。所有患者术后最佳矫正视力均有提高,平均最佳矫正视力自术前(0.19±0.11)提高至术后(0.57 ±0.14),(t=11.45,P＜0.01)。患者角膜散光术前平均为(0.80±0.21)D,术后散光平均为(0.78±0.3)D(t=0.19,P=0.85)。1例患者术后第一天出现一过性低眼压合并脉络膜脱离,药物控制一周内恢复。2例患者术后第一天出现少许前房出血,第二天出血自行吸收。2例患者末次随访时发生包裹性囊肿,眼压再次升高。结论 Ahmed青光眼引流阀植入联合1.8 mm微切口超声乳化手术是治疗难治性青光眼的一种较安全、有效的方法。     

改良小梁切除术160例临床分析

目的探讨小梁切除术的改良方法及疗效。方法对160例（165只眼）原发性闭角型青光眼采用1／3厚度的浅层巩膜瓣、术中前房重建及应用外置可调节缝线的改良小梁切除术，观察术后眼压、滤过泡、视力及术后并发症情况，随访6个月～10年，平均6年2个月。结果165只眼中，158只眼（95．76％）术后眼压控制优良，功能性滤过泡形成157只眼（95．15％），发生Ⅰ、Ⅱ级浅前房11只眼（6．67％），无其他严重并发症发生。结论该改良技术治疗青光眼有助于术后早期前房及滤过泡形成，能主动调整滤过功能，减少并发症发生，提高手术效果，且操作简单易行，便于临床推广应用。