方法：前瞻性研究。选取2012-03/2015-05我院接受治疗的原发性闭角型青光眼患者104例152眼为研究对象，按照随机数将患者平均分为两组，对照组52例71眼，试验组52例81眼。对照组采用常规小梁切除术进行治疗，试验组采用改良小梁切除术进行治疗。比较两组患者视力，术后3、7、30d的眼压，术中前房出血、穿透结膜瓣，术后浅前房发生、虹膜炎症、前房积血、滤道阻塞、角膜水肿以及脉络膜脱离多项并发症的发生情况。

结果：试验组术后平均视力为1.4±0.4，视力提高者42例64眼(79.0%)，对照组平均视力0.8±0.3，视力提高者31例47眼(66.2%)，差异具有统计学意义(P<0.05)； 试验组术后3、7、30d眼压分别为27.3±4.7、20.7±3.8、16.2±4.4mmHg，对照组术后3、7、30d眼压分别为32.6±3.9、26.5±5.1、20.8±4.7mmHg，差异具有统计学意义(P<0.05)； 试验组患者术中前房出血21眼(25.9%)、术中穿透结膜瓣5眼(6.2%)，对照组患者术中前房出血37眼(52.1%)、术中穿透结膜瓣16眼(22.5%)，差异具有统计学意义(P<0.05)； 试验组术后Ⅰ级浅前房14眼(17.3%)、Ⅱ级浅前房11眼(13.6%)、Ⅲ级浅前房2眼(2.5%)，对照组Ⅰ级、Ⅱ级、Ⅲ级患者分别为34眼(47.9%)、18眼(25.4%)、19眼(26.8%)，差异具有统计学意义(P<0.05)； 试验组术后虹膜炎症9眼(11.1%)、前房积血10眼(12.3%)、滤道阻塞6眼(7.4%)、角膜水肿8眼(9.9%)、脉络膜脱离2眼(2.5%)，对照组术后虹膜炎症21眼(29.6%)、前房积血20眼(28.2%)、滤道阻塞15眼(21.1%)、角膜水肿18眼(25.4%)、脉络膜脱离9眼(12.7%)，差异具有统计学意义(P<0.05)。

结论：改良小梁切除术对于治疗原发性闭角型青光眼患者有很好的治疗效果，且能够有效减少并发症的发生。

METHODS: One hundred and four patients with primary angle closure glaucoma from Mar. 2012 to May 2015 were selected as the study subjects. According to the random number table, the patients were divided into two groups, 52 cases of each group. Patients in the control group were treated with conventional trabeculectomy, the experimental group was treated with modified trabeculectomy. Vision restoration of the patients in the two groups were compared. Postoperative 3d, 7d and 30d, the intraocular pressure(IOP)and anterior chamber hemorrhage were compared between two groups, intraoperative penetration conjunctival flap and postoperative shallow anterior chamber occurred. Two groups of patients with postoperative including inflammation of the iris and anterior chamber hyphema, filter channel obstruction, corneal edema and choroidal detachment multiple complications occurrence were compared.

RESULTS: In experimental group, the average visual acuity was 1.4±0.4 improved 42 cases(64 eyes)(80.8%); the average visual acuity in control group was 0.8±0.3 improved 31 cases(47 eyes)(59.6%), the difference was statistically significant(P<0.05). The intraocular pressures of experimental group patients in postoperative 3、7、30d were 27.3±4.7, 20.7±3.8, 16.2±4.4mmHg respectively. The intraocular pressures of control group patients in postoperative 3、7、30d were 32.6±3.9, 26.5±5.1, 20.8±4.7mmHg respectively. The difference was statistically significant(P<0.05). Patients in the test group with hyphema included 21 eyes(25.9%), conjunctival flap surgery penetrate 5 eyes(6.2%). Intraoperative hyphema patients in control group included 37 eyes(52.1%), intraoperative penetrate the conjunctiva flap included 16 eyes(22.5%), the difference was statistically significant(P<0.05). In experimental group, Grade 1 shallow anterior chamber included 14 eyes(17.3%), Grade 2 shallow anterior chamber included 11 eyes(13.6%), Grade 3 shallow anterior chamber included 2 eyes(2.5%). In control group, Grade 1, Grade 2, Grade 3 shallow anterior chamber included 34 eyes(47.9%), 18 eyes(25.4%), 19 eyes(26.8%)respectively, the difference was statistically significant(P<0.05). In experimental group, postoperative inflammation of the iris included 9 eyes(11.1%), hyphema included 10 eyes(12.3%), filter obstruction included 6 eyes(7.4%), corneal edema included 8 eyes(9.9%), choroidal detachment included 2 eyes(2.5%). The inflammation of the iris control group included 21 eyes(29.6%), hyphema included 20 eyes(28.2%), filter obstruction included 15 eyes(21.1%), corneal edema included 18 eyes(25.4%), corneal edema included 9 eyes(12.7%), the difference was statistically significant(P<0.05).

CONCLUSION: Modified glaucoma surgery for the treatment in patients with primary angle-closure glaucoma can get a good clinical effect, and it also can reduce the complication occurred.