目的：探讨玻璃体切割联合青光眼Baerveldt植入物(pars plana vitrectomy and Baerveldt glaucoma implant，PPV-BGI)治疗难治性青光眼的临床疗效。

方法：回顾性分析2013-03/2015-12本院收治并实施PPV-BGI 的129例132眼难治性青光眼患者的临床治疗资料，其中63眼为新生血管性青光眼(neovascular glaucoma，NVG)，69眼为其他类型的青光眼(non-NVG)。分析两组患者的术后眼压(intraocular pressure，IOP)变化、手术结果、视力(visual acuity，VA)、青光眼药物的使用数量、并发症和手术成功率。

结果：NVG组患者和non-NVG组患者1a累计成功率分别为46.0%、81.2%，差异有统计学意义(P<0.05)。NVG组患者IOP 术后1a从术前40.1±10.4mmHg下降至17.8±4.9mmHg，non-NVG组患者则从30.4±10.2 mmHg下降至14.9±4.1mmHg，术前与术后1a相比，差异有统计学意义(P<0.05)。NVG及non-NVG组患者术前青光眼药物使用数量分别为2.9±1.4和2.7±1.2种，术后1a NVG及non-NVG组患者青光眼药物使用数量分别下降为0.96±1.18和0.51±0.96种，差异有统计学意义(P<0.05)。术后NVG组视力改善患者13例14眼，non-NVG组患者改善37例38眼，差异有统计学意义(P<0.05)。术后1d及术后随访1a结果表明，NVG组患者并发症发生情况明显高于non-NVG组，差异有统计学意义(P<0.05)。

结论：PPV-BGI是难治性青光眼手术的一种可行性手术选择，但术后视力恢复效果往往不理想，因为术后往往会有并发症的发生，特别是新生血管性青光眼。

METHODS: One hundred twenty-nine refractory glaucoma patient's clinical data from March 2013 to December 2015 that underwent PPV -BGI were retrospectively reviewed. Among them, 63 eyes were neovascular glaucoma(NVG)and 69 eyes were other types of glaucoma(non-NVG). The changes of intraocular pressure(IOP), surgical results, visual acuity(VA), the number of glaucoma medications, complications, and the success rate of surgery were analyzed.

RESULTS: Cumulative success rates for the NVG group and non-NVG group were 46.0% and 81.2%, respectively, within 1a after surgeries, the difference was significantly(P<0.05). Preoperative IOP was 30.4±10.2mmHg in the non-NVG group and 40.1±10.4mmHg in the NVG group, and IOP was reduced to 14.9±4.1mmHg in the non-NVG group and 17.8±4.9mmHg in the NVG, and the difference was significantly(P<0.05). Number of glaucoma medications decreased from 2.7±1.2 in the non-NVG group and 2.9±1.4 in the NVG group preoperatively to 0.51±0.96 in the non-NVG group and 0.96±1.18 in the NVG group, and the difference was significantly(P<0.05). Improvement in VA of in the NVG group and non-NVG group were observed in 14 eyes of 13 patients and 38 eyes and 37 patients respectively, and the difference was significantly(P<0.05). The postoperative complications of 1d and 1a follow-up in NVG group was significantly higher than non-NVG group(P<0.05).

CONCLUSION: PPV-BGI is a viable surgical option for eyes with refractory glaucoma, but visual outcomes are frequently poor because of ocular comorbidities, especially in eyes with NVG.