目的：探讨改良双瓣形小梁切除术联合羊膜移植治疗难治性青光眼的临床疗效。 方法：分别采用改良双瓣形小梁切除术联合羊膜移植及单纯小梁切除术治疗难治性青光眼患者40例48眼, 术后随访1a，观察比较两组患者术后眼压、滤过泡、视力及并发症等情况。 结果：联合治疗组术后1mo,1a平均眼压分别为11.8±25，12.2±2.1mmHg，与术前及对照组相比，差异均有显著统计学意义（P＜0.01）；术后随访1a均为功能性滤泡，视力较术前有不同程度提高，与对照组相比，差异均有统计学意义（P＜0.05）；术后前房深度及早期并发症情况也明显好于对照组。 结论：改良双瓣形小梁切除术联合羊膜移植治疗难治性青光眼临床效果肯定、并发症少、简单易行、安全可靠，值得基层医院推广应用。

AIM:To explore the clinical efficacy of modified trabeculectomy combined with amniotic membrane implantation on refractory glaucoma treatment.  METHODS: A total of 40 cases (48 eyes) were treated with modified trabeculectomy combined with amniotic membrane implantation and routine trabeculectomy respectively. Comparison of two groups was carried out on the aspects of intraocular pressure (IOP), filtering bleb, visual acuity and complication of operation.  RESULTS:One year after the surgery, no shallow anterior chamber occurred, with normal IOP, functional filtering bleb, improved visual acuity and less complications were in combined treatment group, showing significantly increased benefit when compared to those in routine trabeculectomy.  CONCLUSION:Combined modified trabeculectomy and amniotic membrane implantation is an easy, safe and effective method for treatment of refractory glaucoma, which is suitable for universal promotion."