方法：回顾性分析2014-01/2015-05在荆州市中心医院确诊为难治性青光眼并行Ex-press青光眼微型引流钉植入手术联合术中使用丝裂霉素C患者18例18眼的资料。所有患者至少随访12mo，分析手术前后视力、眼压变化、手术并发症以及滤过泡情况等。

结果：治疗前平均眼压43.83±7.99mmHg，术后1d，1、2wk，1、6、12mo时平均眼压分别为8.72±3.29、11.56±1.86、13.33±2.30、13.67±2.03、14.78±3.64、16.61±7.19mmHg，与术前相比，差异均有统计学意义(t=16.475、15.324、14.761、14.172、12.140、11.412，P均<0.01)； 术后12mo时手术成功率为89%，18例患者中有3例视力提高，12例无明显改变，3例视力下降； 术后并发症：早期并发症主要为前房出血及术后浅前房，晚期为滤过泡功能不良，无严重并发症发生。

结论：Ex-press青光眼微型引流钉植入术联合丝裂霉素C是治疗难治性青光眼安全且有效的方法，手术并发症少，对视力损伤小，且能稳定控制术后眼压。

METHODS: This retrospective analysis comprised 18 eyes of 18 patients who suffered from refractory glaucoma and treated with Ex-press miniature glaucoma device implantation combined mitomycin C in January 2014 to May 2015 in Jingzhou Central Hospital. All patients were followed at least 12mo. The visual acuity, intraocular pressure(IOP), complications and filtering bleb were recorded and statistically analyzed preoperative and 1d, 1, 2wk, 1, 6 and 12mo after operation.

RESULTS: Average intraocular pressure was 43.83±7.99mmHg preoperative and decreased significantly at every time point postoperative(8.72±3.29, 11.56±1.86, 13.33±2.30, 13.67±2.03, 14.78±3.64, 16.61±7.19mmHg respectively), the difference was statistically significant(t=16.475, 15.324, 14.761, 14.172, 12.140, 11.412, P<0.05). The successful rate was 89% at 12mo after operation, and 3 eyes with improved vision, 12 eyes with unchanged vision, 3 eyes with decreased vision. Early complications were mainly anterior chamber bleeding and postoperative shallow anterior chamber, and late complications were non-functional bleb. There were no serious or unexpected complications in our group of patients.

CONCLUSION:The Ex-press miniature glaucoma device implantation combined mitomycin C in the treatment of refractory glaucoma is a safe and effective method, which has few surgical complications and less damage to eyesight, and make the stability control of postoperative intraocular pressure.