目的： 观察改良的Ahmed引流阀植入术治疗难治性青光眼的临床疗效。

方法：回顾性分析2014-01/2018-09在我院行Ahmed引流阀植入手术的难治性青光眼患者30例32眼，按手术方式分为试验组(14例16眼)及对照组(16例16眼)。试验组采用改良Ahmed引流阀植入术，对照组采用传统Ahmed引流阀植入术。观察Ahmed引流阀植入术后1d，1wk，1、3、6mo视力、眼压和并发症等情况。

结果：术前，术后1d，1wk，1、 3、 6mo两组患者眼压无差异(均P>0.05)。术后6mo，两组患者 BCVA较术前无差异(均P>0.05)。术后6mo，试验组手术总成功率为87%，对照组为75%(P=0.654)，试验组平均住院时间(4.50±1.37d)低于对照组(7.63±3.69d)(P=0.003)。试验组术后6mo内未发生浅前房，对照组术后浅前房发生率为31%。

结论：改良Ahmed引流阀植入术治疗难治性青光眼，操作简便，平均住院日短，术后浅前房发生率低，是治疗难治性青光眼的有效方法。

METHODS: A total of 30 patients with refractory glaucoma(32 eyes)selected from our hospital from January 2014 to September 2018 were retrospectively analyzed. According to the treatment methods, they were divided into experimental group(16 eyes treated by modified Ahmed glaucoma valve implantation)and control group(16 eyes treated by traditional Ahmed glaucoma valve implantation). The visual acuity, intraocular pressure, number of anti-glaucoma drugs, the success rate, complications and average length of hospitalization were compared between the two groups, during follow-up at post operative 1d, 1wk, 1mo, 3mo and 6mo.

RESULTS:There was no significant difference in intraocular pressure between the two groups at post-operative 1d, 1wk, 1mo, 3mo, 6mo(all P>0.05). The total success rate was 87%(14/16)in experimental group while 75%(12/16)in control group(P=0.654). BCVA did not improve significantly at post operative 6 mo compared with baseline in both groups(P>0.05). The average length of hospital stay in the experimental group(4.50±1.37d)was significantly lower than that in the control group(7.63±3.69d)(P=0.003). The incidece of shallow anterior chamber was 31% in control group, while in experimental group, it was 0, which showed significant difference.

CONCLUSION: Modified Ahmed drainage valve implantation is an effective method for treating refractory glaucoma, with more simple operations, shorter hospitalizing time and lower incidence of shallow anterior chamber.