AIM: To explore the clinical efficacy of modified glaucoma surgery in the treatment of primary angle closure glaucoma.

METHODS: One hundred and four patients with primary angle closure glaucoma from Mar. 2012 to May 2015 were selected as the study subjects. According to the random number table, the patients were divided into two groups, 52 cases of each group. Patients in the control group were treated with conventional trabeculectomy, the experimental group was treated with modified trabeculectomy. Vision restoration of the patients in the two groups were compared. Postoperative 3d, 7d and 30d, the intraocular pressure(IOP)and anterior chamber hemorrhage were compared between two groups, intraoperative penetration conjunctival flap and postoperative shallow anterior chamber occurred. Two groups of patients with postoperative including inflammation of the iris and anterior chamber hyphema, filter channel obstruction, corneal edema and choroidal detachment multiple complications occurrence were compared.

RESULTS: In experimental group, the average visual acuity was 1.4±0.4 improved 42 cases(64 eyes)(80.8%); the average visual acuity in control group was 0.8±0.3 improved 31 cases(47 eyes)(59.6%), the difference was statistically significant(P<0.05). The intraocular pressures of experimental group patients in postoperative 3、7、30d were 27.3±4.7, 20.7±3.8, 16.2±4.4mmHg respectively. The intraocular pressures of control group patients in postoperative 3、7、30d were 32.6±3.9, 26.5±5.1, 20.8±4.7mmHg respectively. The difference was statistically significant(P<0.05). Patients in the test group with hyphema included 21 eyes(25.9%), conjunctival flap surgery penetrate 5 eyes(6.2%). Intraoperative hyphema patients in control group included 37 eyes(52.1%), intraoperative penetrate the conjunctiva flap included 16 eyes(22.5%), the difference was statistically significant(P<0.05). In experimental group, Grade 1 shallow anterior chamber included 14 eyes(17.3%), Grade 2 shallow anterior chamber included 11 eyes(13.6%), Grade 3 shallow anterior chamber included 2 eyes(2.5%). In control group, Grade 1, Grade 2, Grade 3 shallow anterior chamber included 34 eyes(47.9%), 18 eyes(25.4%), 19 eyes(26.8%)respectively, the difference was statistically significant(P<0.05). In experimental group, postoperative inflammation of the iris included 9 eyes(11.1%), hyphema included 10 eyes(12.3%), filter obstruction included 6 eyes(7.4%), corneal edema included 8 eyes(9.9%), choroidal detachment included 2 eyes(2.5%). The inflammation of the iris control group included 21 eyes(29.6%), hyphema included 20 eyes(28.2%), filter obstruction included 15 eyes(21.1%), corneal edema included 18 eyes(25.4%), corneal edema included 9 eyes(12.7%), the difference was statistically significant(P<0.05).

CONCLUSION: Modified glaucoma surgery for the treatment in patients with primary angle-closure glaucoma can get a good clinical effect, and it also can reduce the complication occurred.