目的：：探讨隧道刀制作双层巩膜瓣并切除层间巩膜瓣的青光眼小梁切除术的临床疗效。方法：采用随机分组方法,将46例60眼青光眼患者分为治疗组24例32眼和对照组22例28眼。前者用隧道刀制作双层巩膜瓣,浅层巩膜瓣大小约为5mm×5.5mm,1/3巩膜厚度,瓣下再做一大小约3.5mm×4mm的巩膜瓣,1/3巩膜厚度,切除中间层的巩膜瓣,切除2mm×2mm小梁组织,常规行虹膜周边切除,可调节缝线缝合浅层巩膜瓣,缝合球筋膜、球结膜；后者行常规青光眼小梁切除术。结果：术后随访1a,治疗组视力明显优于对照组,两组比较差异有统计学意义(P0.05),但术后6,12mo检查发现,治疗组患者的眼压明显低于对照组,差异有统计学意义(P0. 05). But after 6 and 12mo, the intraocular pressure of the treatment group were significantly lower than that of the control group, with statistically significant difference (P<0. 05). Postopeartive 1a, the cumulative complete success rate and conditions for successful rate were 90. 63% and 96. 88% in the treatment group, and those were 75% and 89. 29% in control group. There was significant difference between two groups(P<0. 05).CONCLUSlON:The trabeculectomy have a good effect to lower the intraocular pressure by use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap. The scleral flap have uniform thickness, smooth surface, and the function of the filtering bleb maintained for a long time, less postoperative complications, suitable for various types of glaucoma, so it is worthy of clinical promotion.
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