方法：观察44例44眼难治性青光眼患者，应用23G针头直接穿刺制作巩膜隧道，行青光眼阀植入术进行治疗。观察患者术后眼压、视力、并发症，并与术前进行对比。

结果：本组患者成功率84.1%。术前眼压：52.1±10.1mmHg，最后一次随访眼压15.6±6.9mmHg。视力提高者11眼，视力无改变者27眼，视力降低者6眼。并发症包括：浅前房4例，脉络膜脱离3例，引流管移位1例，前房积血6例，引流管阻塞1例，脉络膜驱逐性出血1例，引流盘包裹5例。

结论：直接穿刺巩膜隧道的方法植入青光眼阀，手术操作简单可行，避免了制瓣及异体巩膜移植，并简化了手术操作，防止术后房水管周渗漏，术后浅前房发生率低，为切实可行的手术方法。

METHODS: Forty-four cases(44 eyes)of refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure(IOP), visual acuity, and complication of post-operation were contrasted with those of pre-operation.

RESULTS:The success rate was 84.1%, the mean preoperative IOP in research group was 52.1±10.1mmHg, and the last follow up mean IOP was 15.6±6.9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber(4 eyes), choroidal detachment(3 eyes), drainage tube shift(1 eye), hyphema(6 eyes), drainage tube blockage(1 eye), expulsive choroidal hemorrhage(1 eye), and fiber wrap of drainage tray(5 eyes).

CONCLUSION: AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. It avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. It is an effective procedure for refractory glaucoma.