方法：选取38例42眼玻璃体切割术后的难治性青光眼患者，在2wk药物洗脱期后，随机分为两组，第一组给予6wk固定联合制剂，第二组给予6wk非固定联合制剂。测量洗脱期后(基线)及用药后6wk眼压、视野、平均视神经纤维层厚度，观察眼部症状及不良反应。

结果：两组患者的基线眼压均值为37.90±3.74，37.57±3.23mmHg，治疗后6wk的眼压均值分别为30.10±4.90，30.62±4.62mmHg，两组较基线眼压均有明显降低(t=12.16，t=13.78，P<0.01)，但两组患者眼压下降的差异无统计学意义(20.54%±7.88%，18.23%±7.03%，t=0.75，P>0.05)。随访观察中，房角开放者(20眼)的平均降压幅度为24.87%，房角部分开放者(15眼)为17.46%，房角关闭者(7眼)为9.65%。对视野及平均视神经纤维层厚度均无改善(P>0.05)。主要不良反应为眼部刺激及轻度充血。

结论：拉坦前列腺素/噻吗洛尔的固定联合制剂能有效降低玻璃体切割术后难治性青光眼患者的眼压，对开角型、房角部分开放型的患者降眼压效果尤为明显。拉坦噻吗滴眼液用药安全，依从性好。

METHODS: In the present study, 42 eyes of 38 refractory glaucoma patients who had received vitrectomy were carried out. The patients were randomly divided into two groups after a 2-week washout period for previous antiglaucoma medication. Patients in group 1 underwent a 6-week treatment with LTFC and those in group 2 were treated with Latanoprost/Timolol unfixed combinations(LTuFC)for 6 weeks. The IOP, visual field, and mRNFL were measured after the washout period as the baseline, and after 6 weeks of therapy. Eye condition and adverse reactions were observed.

RESULTS: The mean baseline IOPs of groups 1 and 2 were respectively 37.90±3.74mmHg and 37.57±3.23mmHg. After 6 weeks, the mean IOPs were respectively 30.10±4.90mmHg and 30.62±4.62mmHg, indicating a significant reduction from the baseline(t=12.16, t=13.78, P<0.01). No difference was observed in the IOP reduction between LTFC and LTuFC(20.54%±7.88%, 18.23%±7.03%, t=0.75, P>0.05). IOP reduction was 24.87%(20 eyes), 17.46%(15 eyes), and 9.65%(7 eyes)respectively among those with open-angle glaucoma, with partially open-angle glaucoma, and with closed-angle glaucoma. The eye drops didn't have effects on the vision field and mRNFL(all P>0.05), and their main adverse reactions were eye irritation and mild hyperemia.

CONCLUSION: In refractory glaucoma, especially in open-angle or partially-open-angle glaucoma, LTFC, administered after vitrectomy, helps to reduce IOP with desirable safetly and tolerance.