AIM: To study the trabeculectomy clinical effect of use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap of glaucoma.

METHODS:Using the random grouping method to divide 46 cases(60 eyes)of glaucoma into the treatment group of 24 cases(32 eyes)and control group of 22 cases(28 eyes). The treatment group, tunnel knife was used to make double-deck sclera flap and superficial scleral flap about the size of 5mm×5.5mm,1/3 scleral thickness, under the sclera flap made another one about the size of 3.5mm×4mm, 1/3 scleral thickness, resected the middle layer of the sclera flap, removed 2mm×2mm trabecular tissue, underwent routine peripheral iridectomy, could adjust suture the superficial scleral flap, sutured Ball fascia and bulbar conjunctiva. In control group, routine glaucoma trabeculectomy was undergone.

RESULTS:Patients were followed up for 1a, the vision in treatment group was obviously better than that in the control group, with a statistically significant difference(P<0.05). The postoperative intraocular pressure of the two groups of patients were significantly lower than that of the preoperative one. Postoperative 1 and 3mo, no statistical significant difference of intraocular pressure in two group(P>0.05). But after 6 and 12mo, the intraocular pressure of the treatment group were significantly lower than that of the control group, with statistically significant difference(P<0.05). Postopeartive 1a, the cumulative complete success rate and conditions for successful rate were 90.63% and 96.88% in the treatment group, and those were 75% and 89.29% in control group. There was significant difference between two groups(P<0.05).

CONCLUSION:The trabeculectomy have a good effect to lower the intraocular pressure by use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap. The scleral flap have uniform thickness, smooth surface, and the function of the filtering bleb maintained for a long time, less postoperative complications, suitable for various types of glaucoma, so it is worthy of clinical promotion.