方法：选取33例34眼原发性闭角型青光眼患者均实行复合式小梁切除术，其中A组：18例18眼患者经联合用药48～72h后，眼压仍在35mmHg以上，在高眼压下施行复合式小梁切除术； B组：15例16眼患者经过药物治疗后眼压降至21mmHg以下，施行复合式小梁切除术。术后观察视力、眼压。

结果：患者34眼均顺利完成手术，未发生爆发性脉络膜出血等严重的并发症。术后随访6～18mo，两组患者手术前后视力均有明显改善，分别由术前0.02±0.01、0.04±0.02提高到0.2±0.06、0.3±0.07，差异有统计学意义(P<0.01)； 30眼眼压均控制在9～23mmHg，3眼联合降眼压药物后眼压控制正常，1眼滤过失败，A、B组患者术后眼压较术前明显降低，差异有统计学意义(P<0.01)，基本降至正常，分别为17.9±9.1、15.4±8.4mmHg，两组患者术后眼压无统计学差异(P>0.05)。

结论：对于持续高眼压下的原发性闭角型青光眼，应果断考虑高眼压下施行复合式小梁切除术，以防视功能进一步损害甚至丧失。只要术前全面考虑，术中精心操作，术后仔细护理，持续高眼压下的原发性闭角型青光眼施行复合式小梁切除术是安全、有效的。

METHODS:Thirty-three cases(34 eyes)with primary angle-closure glaucoma were executed compound trabeculectomy. All patients were divided into two groups: group A: 18 cases(18 eyes)were executed compound trabeculectomy under high intraocular pressure higher than 35mmHg after using IOP-lowering medicine for 48-72h; group B: 15 cases(16 eyes)were executed compound trabeculectomy, the intraocular pressure was normal after using IOP-lowering medicine.

RESULTS:Thirty-four eyes were successfully completed surgery with follow-up of 6 to 18mo and there were no serious complications, including suprachoroidal hemorrhage. The visual acuity before operation in group A and group B were 0.02±0.01, 0.04±0.02, respectively. And the postoperative visual acuity in group A and group B increased 0.2±0.06, 0.3±0.07, respectively(P<0.01). All of them, intraocular pressure with 30 eyes were controlled in 9-23 mmHg, 3 eye was controlled by normal through adding in several kinds different IOP-lowering medicine. One eye was failure. Compared to preoperation, postoperative intraocular pressure of two groups were decreased by normal, which were 17.9±9.1 mmHg and 15.4±8.4mmHg, respectively(P<0.01). There was no significant difference between two groups for postoperative intraocular pressure.

CONCLUSION: The primary angle-closure glaucoma with persistent high intraocular pressure should be executed compound trabeculectomy decisively, even under high intraocular pressure, which prevent further damage and loss of visual function. As long as to fully consideration the preoperation, intraoperative careful operation, careful nursing, it is safety and effective to have compound trabeculectomy under the continuous high intraocular pressure for primary angle-closure glaucoma.