方法：回顾2013-01/2015-05在我院就诊的确诊为原发性开角型青光眼患者23例29眼。患者年龄23～42岁，术前最佳矫正视力：指数/50cm～0.5，眼压16～52mmHg。给予降眼压药物效果不理想，行Ex-PRESS引流钉植入联合调整缝线手术。术后进行眼压、滤过泡形成观察及超声生物显微镜(ultrasound biomicroscope，UBM)观察引流钉开口是否通畅。

结果：术后视力0.06～0.5； 术后1wk平均眼压为10±3mmHg，与术前比较明显降低(P<0.05)； 手术后有1眼出现术后浅前房，1眼术后第2d出现前房积血； 所有患者(29眼)在术后至术后1wk拆除调整缝线期间滤过泡形成好，有1眼术后3mo复查滤过泡包裹，UBM检查巩膜内口有高密度强回声阻塞物，而无巩膜瓣下通道，其他患者(28眼)术后3mo UBM 观察滤过通道通畅。

结论：Ex-PRESS青光眼引流钉植入术联合调整缝线治疗开角型青光眼是安全有效的，术中及术后风险低、并发症少。

METHODS:The clinical data of 23 patients(including 29 eyes)from January 2013 to May 2015 who were diagnosed as primary open angle glaucoma were analyzed retrospectively. These patients who were 23～42 years old with the best corrected visual acuity(BCVA)from 50cm/finger count to 0.5 and the intraocular pressure(IOP)16～52mmHg did not respond well after using IOP-lowering drugs. After being treated with Ex-PRESS glaucoma drainage device associated with adjustable suture, the BCVA,IOP and the formation of filtering blebs were observed, while ultrasound biomicroscope(UBM )was used to observe whether the Ex-PRESS drainage device filterable passage was open or not.

RESULTS:The mean BCVA was 0.06～0.5 postoperatively; the mean IOP was 10±3mmHg at 1wk after treatments, which decreased significantly compared to that before treatments(P<0.05). Postoperative complications included 1 eye with shallow anterior chamber and 1 eye with anterior chamber hyphema on the second day after operation. The formation of filtering blebs in all the patients(29 eyes)were achieved successfully after disconnecting dermal sutures within 1wk postoperatively, except 1 eye of which filtering bleb was muffled at 3mo postoperatively. After examined by UBM, it was found that there was high density and hyper echoic obstruction,but no visible sclerotic filterable passage. The filterable passages in other 28 eyes were unobstructed by UBM examination.

CONCLUSION: Ex-PRESS glaucoma drainage device with adjustable suture for primary open-angle glaucoma is considered safe and effective. It is obvious that this clinical therapeutic technique is an ideal method with a low incidence of intraoperative risk and postoperative complications.