目的：研究噻吗洛尔与拉坦前列素联合应用对高眼压型原发性开角型青光眼(primary open angle glaucoma， POAG)患者视盘参数及视网膜神经纤维层厚度的影响，为临床研究提供指导。

方法：将2013-11/2015-11期间于我院进行治疗的240例336眼高眼压型POAG患者按随机数字表法将患者分为两组，其中对照组120例170眼，观察组120例166眼。对照组患者仅采用拉坦前列素治疗，观察组则采用噻吗洛尔联合拉坦前列素进行治疗。观察治疗后3mo内患者治疗效果，测量患者视盘参数和视网膜神经纤维层厚度，随访关注1a内患者不良反应发生率。

结果：观察组和对照组患者治疗后的改善率分别为97.6%和80.6%，观察组疗效明显优于对照组，两组比较差异有统计学意义(P<0.05)； 治疗后两组患者眼部盘沿面积、盘沿容积、视盘容积和水平杯盘直径比均有所升高，差异有统计学意义(P<0.05)，其中观察组显著高于对照组，差异有统计学意义(P<0.05)，而两组患者的垂直杯盘直径明显下降，差异有统计学意义(P<0.05)，观察组显著低于对照组，差异具有统计学意义(P<0.05)； 两组患者治疗期间眼睛干涩、角膜浸润、结膜充血、视觉模糊等并发症发生率比较差异无统计学意义(P>0.05)，1a内随访患者也无其他不良反应发生。

结论：采用噻吗洛尔与拉坦前列素联合应用治疗高眼压型POAG患者，患者病情有明显好转，视力得到提高，其视盘参数和视网膜神经纤维层厚度也有所改善。

METHODS: Totally 240 patients(336 eyes)with high intraocular pressure type POAG in our hospital from November 2013 to November 2015 were randomly divided into control group and observation group, and each with a total of 120 cases(170 and 166 eyes, respectively). The patients in control group only received latanoprost treatment, while the observation group was treated with timolol and latanoprost treatment. After 3mo of treatment, we observed the therapeutic effects, and measured the optic disc parameters and retinal nerve fiber layer thickness. The incidence of adverse reactions was observed in the following 1a.

RESULTS: The patients of observation group and the control group after treatment showed the improvement rates of 97.6% and 80.6%, respectively, and the observation group was significantly better than the control group, the two groups showed statistically significant(P<0.05). The eye rim area, rim volume, rim volume and diameter of two groups after treatment were higher than before(P<0.05), while those of the observation group was significantly higher than control group(P<0.05). Two groups of patients with vertical cup to disc diameter decreased obviously(P<0.05), the observation group was significantly lower than the control group, the difference was statistically significant(P<0.05). Between the two groups of patients, during the period, incidences of dry eyes, corneal and conjunctival hyperemia, infiltration blurred vision and other complications had no significant difference(P>0.05), and the 1a follow-up of patients showed no other adverse reactions.

CONCLUSION: The use of timolol and latanoprost therapy for high intraocular pressure type POAG patients showed that the patients improve obviously, the visual acuity has more improved and the parameters of optic disc and retinal nerve fiber layer thickness are also improved.