AIM: To observe the clinical effects of trabeculectomy with incision of “W” form and adjustment suture for primary angle-closure glaucoma(PACG).

METHODS: In a prospective randomized sample controlled clinical study, 48 patients(48 eyes)were randomly divided into two groups:(group A)trabeculectomy with incision of “W” form and adjustment suture;(group B)traditional compound trabeculectomy surgery. The vision, intraocular pressure, astigmatism, ocular surface disease index(OSDI), tear film function, filtering bleb, success rate of operation and postoperative complications were performed at 1 week, 3 months and 6 months postoperatively.

RESULTS:There were no significant difference for corneal astigmatism, OSDI and tear film function between two groups preoperatively( t_astigmatism=0.764,t_OSDI=0.652,t_{break up time} =-1.837, t_{tear river altitude} =-1.535, t_ST=-1.821, t_FL=1.916,P>0.05). There were no statistically significance for OSDI, break up time(BUT), Schirmer test(ST), tear river altitude and fluorescein staining(FL)at 1 week post-operation in group A compared with the fellow eyes(t_AOSDI =1.052, t_ABUT=0.974, t_{Atear river altitude} =0.998, t_AST =-1.225, t_AFL =0.784, P>0.05), whereas statistically significance at 1 week post-operation in group B compared with the fellow eyes(t_BOSDI =14.538,t_BBUT=5.241, t_{Btear river altitude} =2.694, t_BST =-3.189, t_BFL =-1.355,P<0.05). There were no statistically significance for symptom eyes, OSDI, BUT and FL at 2 weeks post-operation in both groups compared with the fellow eyes(t_AOSDI =0.828,t_ABUT=0.537, t_{Atear river altitude} =0.662, t_AST = -0.691, t_AFL =0.046; t_BOSDI =0.774,t_BBUT=1.082, t_{B tear river altitude}=0.629, t_BST =-0.558, t_BFL =-0.719, P>0.05). There were statistically significance for surgically induced astigmatism, filtering bleb in both groups(t _astigmatism=9.964, χ² _{filtering bleb}=9.662,P<0.05), whereas no statistically significance on vision, intraocular pressure, cumulative survival rate of functional filter blebs and success rate of operation in both groups(P>0.05).

CONCLUSIONS: Trabeculectomy with incision of “W” form and adjustment suture is a more favorable solution for primary angle-closure glaucoma patients, which can stabilize the tear film,mitigate the symptom of ocular surface and corneal astigmatism, and therefore improve the visual quality.