目的：探讨复合式小梁切除术治疗原发性开角型青光眼行非穿透小梁切除术后眼压失控（眼压升高）的长期疗效与安全性。方法：回顾分析了2006-03/2011-07非穿透小梁切除术治疗原发性开角型青光眼术后眼压失控（眼压升高）再次行小梁切除术的连续随访患者13例25眼。青光眼术后再次眼压异常升高,均属于难治性青光眼,我们采取复合式小梁切除术,对于仅存中心视岛及管状视野患眼,手术在表面麻醉联合球筋膜浸润麻醉下实施。主要检查指标：手术前后眼压、视力、角膜水肿情况、滤过泡特征、前房深浅及其它并发症。结果：随访3mo～5a,非接触眼压测定术前眼压28～52mmHg,术后眼压11.7～18mmHg,术后3mo,眼压为145mmHg,眼压以≤21mmHg为成功标准。术后3mo,视力提高3眼（12%）,视力不变17眼（68%）,视力下降5眼（20%）；术后21眼角膜均变清亮；功能性滤过泡22眼（80%）,有3眼为非功能性滤过泡,眼压再次高于21mmHg,二次进行复合式小梁切除术后眼压控制在21mmHg以下；术后有15眼（60%）出现前房轴深在1.5～2CT间,均自行恢复；术中、术后有10眼（40%）出现不同程度的前房出血,经对症治疗后均已吸收；术后有5例5眼（20%）出现房水闪辉,经散瞳及典必殊滴眼液进行眼局部频点后房水闪辉完全消失,未发生眼内炎等并发症。结论：小梁切除术目前仍是可挽救有视力眼的青光眼最经典、最有效的方法；复合式小梁切除术是原经典手术方式的进一步发展；青光眼术后眼压再次异常升高均属于难治性青光眼,原发性开角型青光眼行非穿透小梁切除术后眼压失控应用复合式小梁切除术再次治疗,证实安全有效,长期疗效满意,是弥补非穿透小梁切除术眼压失控（升高）后有效的治疗措施,并且可以一眼多次手术；有效地保护仅存的视力,维持了一定的视功能；晚期原发性开角型青光眼不适合非透性小梁手术。

AIM:To research the long-term curative effectiveness and safety of compound trabeculectomy for primary open angle glaucoma(POAG) with intraocular pressure elevation after non-penetrating trabeculectomy. METHODS:Thirteen cases (25 eyes) who underwent compound trabeculectomy for (POAG) with intraocular pressure(IOP) elevation after non-penetrating trabeculectomy treated in our hospital during March 2006 to July 2011 were retrospectively analyzed. Glaucoma with high IOP after operation belonged to refractory glaucoma. Compound trabeculectomy was used to treat glaucoma eyes with central island and tubular vision under topical anesthesia combined tenon anesthesia. Those factors were taken into account such as IOP, visual acuity, cornea, filtering bleb, anterior chamber depth and complications.RESULTS:All patients were followed up for 3 months to 5 years. The IOP was 28-52mmHg before the operation, and 11.7-18mmHg postoperatively. At the last visit 3 months after operation the IOP was 14.5mmHg. We set the IOP ≤21mmHg for success criteria. Three months later, vision was improved in 3 eyes (12%) , unchanged in 17 eyes (68%), declined in 5 eyes (20%), and in 25 eyes (100%) , cornea became transparent .There were 22 eyes (80%) with functional filtering blebs. The other 3 eyes with IOP elevation and non-function filtering blebs were also cured by compound trabeculectomy. The incidence of shallow anterior chamber, hyphema, and aqueous flare was 60%, 40%, 20%, and those signs disappeared after treatment. There was no occurring of complication such as endophthalmitis.CONCLUSION:Compound trabeculectomy is the further development of trabeculectomy, which is the most classic and effective way for glaucoma. Compound trabeculectomy for the treatment of POAG with ocular hypertension was found to have a long term curative effectiveness and safety. Compound trabeculectomy, as a supplementary means of ocular hypertension after non-penetrating trabecular operation, effectively protect the remaining vision. But advanced POAG is not suitable for non-penetrating trabeculectomy. 