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(P<0.05)。两组患者术后眼压均明显低于术前眼压。术后1，3mo时，两组患者的眼压比较差异无统计学意义(P>0.05)，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(P<0.05)。术后1a治疗组和对照组的累积完全成功率分别为90.63%和75%，两组的累积条件成功率分别为96.88%和89.29%，两组比较差异有统计学意义(均P<0.05)。

结论：隧道刀制作双层巩膜瓣并切除层间巩膜瓣的小梁切除术降眼压效果好，巩膜瓣厚薄均匀、表面光滑，滤过泡功能维持时间长，术后并发症少，适用于多种类型的青光眼，值得临床推广。

METHODS:Using the random grouping method to divide 46 cases(60 eyes)of glaucoma into the treatment group of 24 cases(32 eyes)and control group of 22 cases(28 eyes). The treatment group, tunnel knife was used to make double-deck sclera flap and superficial scleral flap about the size of 5mm×5.5mm,1/3 scleral thickness, under the sclera flap made another one about the size of 3.5mm×4mm, 1/3 scleral thickness, resected the middle layer of the sclera flap, removed 2mm×2mm trabecular tissue, underwent routine peripheral iridectomy, could adjust suture the superficial scleral flap, sutured Ball fascia and bulbar conjunctiva. In control group, routine glaucoma trabeculectomy was undergone.

RESULTS:Patients were followed up for 1a, the vision in treatment group was obviously better than that in the control group, with a statistically significant difference(P<0.05). The postoperative intraocular pressure of the two groups of patients were significantly lower than that of the preoperative one. Postoperative 1 and 3mo, no statistical significant difference of intraocular pressure in two group(P>0.05). 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).

CONCLUSION: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.