方法：选取2013-01/2016-01在我院眼科确诊并住院治疗的60例60眼难治性青光眼患者作为研究对象，根据手术方式分为研究组和对照组，研究组采用EX-PRESS青光眼引流器联合超声乳化白内障吸出术+人工晶状体植入术，对照组采用小梁切除联合白内障超声乳化+人工晶状体植入术进行治疗。研究组29例29眼，对照组31例31眼。检查并记录两组患者术后1d，1、3、6mo的视力、眼压、手术成功率等临床指标及并发症发生情况。

结果：本组60例60眼患者均顺利完成手术，研究组成功率为93%，对照组成功率为81%； 研究组手术成功率虽明显高于对照组，但差异无统计学意义(P=0.26)。在术后6mo时两组患者的最佳矫正视力均有所提高，组内比较，研究组和对照组最佳矫正视力均高于术前，但差异无统计学意义。两组患者术后最佳矫正视力情况比较差异无统计学意义。在眼压方面，两组间眼压差异有统计学意义(P<0.05)，时间点对眼压的影响有统计学意义(P<0.05)。术后1d，1、3mo，研究组患者的眼压均显著低于对照组患者，差异均有统计学意义(P<0.05)； 而在术后第6mo时，两组患者的眼压情况差异无统计学意义(P>0.05)。术后各时间点与术前比较均有统计学意义(P<0.05)，术后1d与术后6mo比较有统计学意义(P=0.007)，其他两两比较结果无统计学意义。

结论：EX-PRESS青光眼引流器植入联合白内障超声乳化+人工晶状体植入术治疗难治性青光眼合并白内障有较好的临床效果，是一种有较高可行性、安全性以及有效性的治疗方案。

METHODS: Totally 60 patients(60 eyes)of refractory glaucoma were chosen as the research objects between January 2013 and January 2016 in our hospital, who were divided into research group and the control group according to the operation method. Research group(29 patients 29 eyes)was given EX-PRESS glaucoma drainage device combined with phacoemulsification and intraocular lens implantation; control group(31 patients 31 eyes)was given trabeculectomy combined with phacoemulsification and intraocular lens implantation. The visual acuity, intraocular pressure(IOP), the successful rate and other clinical indicators were observed and analyzed.

RESULTS: The surgery of all the 60 patients achieved success.The successful rate of research group was 93%, that of control group was 81%, while the difference was not significant(P=0.26). The best corrected visual acuity(BCVA)of both groups was better than before treatment at 6mo after surgery without statistically significant. The postoperative BCVA was not different between the two groups. The IOP between the two groups was significantly different(P<0.05). The IOP of research group at 1d, 1 and 3mo was significantly lower than control group(P<0.05). The IOP at 6mo after surgery was not significantly between the two groups. The IOP at different time was significantly different(P<0.05). The IOP at 1d after surgery was significantly different compared to that at 6mo(P=0.007).

CONCLUSION:It has good clinical effect that EX-PRESS glaucoma filtration device combined with phacoemulsification for refractory glaucoma complicated with cataract. It is a treatment with high feasibility, safety and effectiveness.