方法：对28例30眼青光眼合并白内障患者行改良的单穿刺双切口青光眼白内障联合手术。常规白内障超声乳化手术(10：00位透明角膜切口)后，11：00～1：00位距角膜缘后2mm处剪开球结膜及Tenon囊，3mm穿刺刀于角膜缘后2mm穿刺入前房，作一3mm宽、1/3～1/4巩膜厚度的巩膜隧道，伸入小梁咬切器，咬除3块约1mm×1mm大小小梁组织。术后随访3～6mo观察视力、眼压、滤过泡形态(OCT检测)及并发症的情况。

结果：术后1wk，视力<0.1者3眼，0.1～者6眼，0.3～者13眼，0.6～0.8者8眼； 1眼发生恶性青光眼，8眼早期角膜水肿及瞳孔区轻微纤维素渗出； 30眼均为功能性滤过泡(Ⅰ型、Ⅱ型滤过泡)，OCT显示滤过口通畅； 随访3～6mo，28眼眼压在正常范围内，2眼出现眼压控制不良。

结论：单穿刺双切口青光眼白内障联合手术简单易行，手术效果良好，术后并发症少，值得推广。

METHODS: Totally 28 cases(30 eyes)with glaucoma and cataract undertook the modified combined surgery of single-stab trabeculectomy and phacoemulsification. After traditional phacoemulsification, cut the bulbar conjunctiva and Tenons capsule from the 11 o'clock to 1 o'clock, then puncture into the anterior chamber in 2mm behind the corneal limbus with 3mm tunnel knife, shaping a 3mm wide, 1/3-1/4 thickness scleral tunnel. Getting into the trabecular tunnel, bite off 3 pieces of trabecular tissue about 1mm×1mm size. The changes in the imtraocular pressure(IOP)and the visual acuity before and after the surgery as well as filtering bleb(OCT confirmed)and complications were carefully observed in 3-6mo postoperatively.

RESULTS: The postoperative visual acuity in 1wk postoperatively less than 0.1 was found in 3 eyes, from 0.1 to 0.3 was found in 6 eyes,from 0.3 to 0.6 in 13 eyes,from 0.6 to 0.8 in 8 eyes.One eye had malignant glaucoma, and 8 eyes had cornea edema and slightly fibrin exudation in the pupil area; In all cases maintained function conjunctival blebs of filtering, OCT confirmed this.IOP remained normal in 28 eyes in 3-6mo follow up, IOP of 2 other eyes could be controlled by anti-glaucoma eye drops.

CONCLUSION:Double incision combined surgery of single-stab trabeculectomy and phacoemulsification is effective and safe,reduces the postoperative complications and is worthy of promotion.