目的：评估四环单结调整缝线引流管结扎技术在Ahmed青光眼阀(AGV)植入术中的应用效果。

方法：回顾性分析。纳入2020-05/2022-01 本院眼科中心进行AGV植入术治疗的难治性青光眼患者78例78眼， 按手术方式分为改良AGV植入术组(43眼，使用四环单结调整缝线对引流管进行结扎)和传统AGV植入组(35眼，不使用四环单结调整缝线对引流管进行结扎)。随访6mo，观察两组患者术后1d，1、2wk，1、6mo眼压，手术成功率和并发症发生情况。

结果：两组患者术后1d，1、2wk，1、6mo眼压均较术前明显降低(均P<0.05)； 两组组间各时间点眼压比较均无差异(均P>0.05)。术后1wk，改良AGV植入术组和传统AGV植入组浅前房发生率分别为5%和23%(P<0.05)。术后6mo，改良AGV植入术组总体成功率为98%，传统AGV植入组为89%(P>0.05)。

结论：AGV植入术中采用四环单结调整缝线结扎引流管可以有效降低眼压，减少术后早期浅前房的发生率，手术安全有效。

METHODS: A total of 78 patients(78 eyes)with refractory glaucoma who underwent AGV implantation in the People's Hospital of Leshan from May 2020 to January 2022 were retrospectively analyzed. According to the treatment, the patients were divided into the modified AGV implantation group, with 43 patients(43 eyes)treated by modified AGV implantation, ligating the drainage tube with single-pass four-throw releasable suture, and the traditional AGV implantation group, with 35 patients(35 eyes)treated by traditional AGV implantation. Followed-up for 6mo, the intraocular pressure(IOP), success rate and complications were observed at 1d, 1 and 2wk and 1 and 6mo after operation.

RESULTS: Postoperative IOP at all follow-up visits was significantly lower than that before surgery in both groups(all P<0.05). There was no significant difference in IOP between groups at all follow-up visits(all P>0.05). The incidence of shallow anterior chamber was 5% in the modified AGV implantation group and 23% in the traditional AGV implantation group at 1wk after surgery(P<0.05). At 6mo after operation, the overall success rate was 98% in modified AGV implantation group and 89% in the traditional AGV implantation group(P>0.05).

CONCLUSION:During AGV implantation, ligation of drainage tube with single-pass four-throw releasable suture can effectively reduce IOP and reduce the incidence of shallow anterior chamber in early postoperative stage. Furthermore, the technique is safe and efficacious.