目的：探究EX-PRESS青光眼引流器植入术及小梁消融术对原发性开角型青光眼(POAG)合并白内障患者视力、眼压、中央前房深度(ACD)及术后并发症的影响。

方法：回顾性分析2015-03/2017-01我院64例64眼POAG合并白内障患者的临床资料，其中34例34眼行EX-PRESS青光眼引流器植入联合白内障超声乳化术(A组)，30例30眼行小梁消融联合白内障超声乳化术(B组)。比较两组术前及术后5mo时最佳矫正视力(best corrected visual acuity，BCVA)、眼压、ACD、黄斑区神经节细胞复合体(GCC)厚度差异，并记录两组术后并发症发生情况差异。

结果：术后5mo时，两组BCVA、眼压均较术前降低，差异亦有统计学意义(t_A组=39.359、21.045，t_B组=23.126、16.863，均P<0.01)，且A组低于B组，差异具有统计学意义(t=9.452、2.761，均P<0.01)。两组手术前后ACD水平组间及组内比较差异均无统计学意义(P>0.05)； 术后5mo时，A组黄斑区GCC厚度与术前比较差异无统计学意义(P>0.05)，但B组黄斑区GCC厚度则较术前降低，差异有统计学意义(t=3.851，P<0.05)，且低于A组，差异具有统计学意义(t=2.269，P<0.05)。A组术后并发症发生率明显较B组低，差异具有统计学意义(χ²=7.883，P<0.05)。

结论：EX-PRESS青光眼引流器植入术及小梁消融术联合白内障超声乳化术对POAG合并白内障患者治疗效果均较好，但前者降眼压与提高视力效果优于后者，且EX-PRESS青光眼引流器植入术能减少术后并发症发生率，减轻视网膜神经节细胞(RGCs)损害，对患者病情转归有利。

AIM:To explore the effects of EX-PRESS glaucoma drainage device implantation and trabectome on visual acuity, intraocular pressure, central anterior chamber depth(ACD)and postoperative complications in patients with primary open angle glaucoma(POAG)complicated with cataract.

METHODS: The clinical data of 64 patients(64 eyes)with POAG complicated with cataract in our hospital from March 2015 to January 2017 were retrospectively analyzed. Among them, 34 patients(34 eyes)were given EX-PRESS glaucoma drainage device implantation and cataract phacoemulsification(the Group A)and another 30 cases(30 eyes)were given trabectome combined with cataract phacoemulsification(the Group B). The visual acuity \〖best corrected visual acuity(BCVA)\〗, intraocular pressure, ACD and the thickness of macular ganglion cell complex(GCC)were compared between the two groups before operation and at 5mo after operation, and the differences of postoperative complications were also recorded between the two groups.

RESULTS: At 5mo after operation, the BCVA, intraocular pressure(IOP)was lower than that before operation(t _{Group A}=39.359, 21.045; t _{Group B}=23.126, 16.863; P<0.01), and the Group A was lower than that in the Group B(t=9.452, 2.761; P<0.01). There was no significant difference in the ACD level before and after operation between-groups and within-groups(P>0.05). At 5mo after operation, there was no significant difference in the thickness of macular GCC in the Group A compared with that before operation(P>0.05), but the thickness of macular GCC in the Group B was lower than that before operation(t=3.851, P<0.05)and was lower than that in the Group A(t=2.269, P<0.05). The incidence rate of postoperative complications in the Group A was significantly lower than that in the Group B(χ²=7.883, P<0.05).

CONCLUSION: EX-PRESS glaucoma drainage device implantation or trabectome combined with cataract phacoemulsification can receive good treatment effects in treating POAG patients with cataract, but the former one has better effects on reducing IOP and improving visual acuity than those in the latter one. And EX-PRESS glaucoma drainage device implantation can reduce the incidence rate of postoperative complications, and it is also beneficial to the reduction of retinal ganglion cells(RGCs)damage and the disease prognosis.