方法：回顾性病例对照研究。收集2017-01-01/2019-01-01在我院眼科确诊并住院治疗的CPACG合并白内障患者(29例36眼)作为研究对象，按手术方式不同分为两组，研究组(13例16眼)采用EX-PRESS引流器植入术联合超声乳化白内障摘除人工晶状体植入术，对照组(16例20眼)采用小梁切除术联合超声乳化白内障摘除人工晶状体植入术。记录两组术前，术后1wk，1、3、6mo最佳矫正视力(BCVA)、眼压，术前，术后1、6mo的中央前房深度(ACD)、中央角膜内皮细胞数、手术时间、手术至出院时间、术中术后并发症、术后随访情况等。

结果：两组患者的人口基线特征无差异(均P>0.05)。研究组术后6mo与术前相比视力改善眼数增多(Z=-2.066，P=0.039)，术后6mo时两组的视力无差异(Z=-0.319，P=0.765)。研究组术后1wk，1、3、6mo的眼压与术前相比均下降(均P<0.001)，两组的眼压无差异(F=0.003，P=0.956)。两组术后1、6mo ACD均较术前加深(均P<0.001)，两组的ACD、中央角膜内皮细胞数均无差异(P>0.05)。手术时间研究组26.1±4.5min，对照组31.5±5.1min，两组有差异(t=-3.307，P=0.002)。手术至出院时间研究组7.2±1.6d，对照组7.7±1.5d，两组无差异(t=-0.880，P=0.388)。研究组1眼EX-PRESS触及虹膜，因眼压正常未做处理。对照组2眼术后2度浅前房，采用散瞳及加压包扎1wk后恢复。术后6mo时两组各有1眼用1种降眼压滴眼液维持眼压正常。对照组1眼12mo后因眼压升高行EX-PRESS引流器植入术，1眼8mo后行睫状体光凝术。

结论：EX-PRESS引流器植入术联合超声乳化术治疗CPACG可以提高视力、降低眼压，取得良好疗效，手术时间短于小梁切除术联合超声乳化术。

METHODS: A retrospective case control design was used in this study. The patients underwent combined operation of glaucoma and cataract in the ophthalmology department of our hospital from January 1^st, 2017 to January 1^st, 2019 were collected and divided into two groups according to different operation methods. The study group(13 cases, 16 eyes)was treated with EX-PRESS drainage device implantation combined with phacoemulsification and intraocular lens implantation. The control group(16 cases, 20 eyes)was treated with trabeculectomy combined with phacoemulsification and intraocular lens implantation. The best corrected visual acuity(BCVA)and intraocular pressure(IOP)at 1wk, 1, 3, 6mo after surgery, central anterior chamber depth(ACD)at before surgery, 1, 6mo after surgery, central corneal endothelial cell count, the duration of operation, length of hospital stays after surgery were compared between the two groups.

RESULTS:The demography was matched between the two groups(all P >0.05). The number of eyes with visual improvement was significantly raised 6mo after treatment in study group(Z=-2.066,P=0.039). There were no significant differences in BCVA between two groups 6mo after treatment(Z=-0.319,P=0.765). The IOP of study group at 1wk, 1, 3 and 6mo was significantly lower than that before operation(all P<0.001). There were no significant differences in IOP between the two groups(F=0.003, P=0.956). The anterior chamber significantly deepened at 1 and 6mo after operation in two groups respectively(all P<0.001). There were no significant differences in ACD and central corneal endothelial cells count between two groups(all P>0.05). The duration of operation was 26.1±4.5min in study group and 31.5±5.1min in control group, which showed significant differences(t=-3.307, P=0.002). The length of stays after surgery was 7.2±1.6d in study group and 7.7±1.5d in control group, and there was no significant difference between the two groups(t=-0.880, P=0.388). One eye EX-PRESS touched the iris in study group. Since the IOP was normal, it didn't receive therapy. In control group, the anterior chamber of 2 eyes was 2 degrees shallow after surgery, which recovered in 1wk by pupil dilation and pressurized bandage. At 6mo point after operation, one eye in each group was treated with one IOP drop to maintain normal IOP. In control group, one case received EX-PRESS drainage device implantation again 12mo later for recurrent glaucoma, another case underwent ciliary body photocoagulation 8mo later.

CONCLUSION: EX-PRESS drainage device combined with phacoemulsification is effective in improving visual acuity and controlling IOP for CPACG, and it takes shorten operation time compared with trabeculectomy combined with phacoemulsification.