摘要目的：对比分析Schlemm管成形术与房水流出通路重建术治疗开角型青光眼的安全性和有效性。方法回顾性系列病例研究。对已行Schlemm管成形术（第1组）的13例（17只眼）和房水流出通路重建术（第2组）的12例（14只眼）开角型青光眼患者进行分析。比较两种术式在手术成功率、眼压下降幅度、术后用药数量、并发症等方面的差异。采用独立样本t检验比较两组间术前、术后1、3、6、12个月眼压以及术前、术后降眼压药物使用数量。使用Kaplan-Meier生存分析统计两种手术方式的成功率，并用Log rank test比较两组6个月及1年时累计成功率的差异。结果第1组患者术前、术后1、3、6、12、24个月的眼压分别为（24.7±8.7）、（14.5±2.5）、（14.9±2.5）、（14.9±2.5）、（14.7±2.1）、（15.4±2.3） mmHg（1 mmHg＝0.133 kPa）；第2组术前、术后1、3、6、12、24个月的眼压分别为（28.5±10.6）、（14.3±3.6）、（14.2±3.2）、（14.3±3.6）、（15.9±3.2）、（14.6±0.7） mmHg，两种术式术前和术后眼压，在各个随访时间点差异均无统计学意义（术前：t＝-1.1014， P＝0.278；术后1个月：t＝0.696，P＝0.492；术后3个月：t＝0.594，P＝0.557；术后6个月：t＝0.536， P＝0.596；术后12个月：t＝-1.127， P＝0.273；术后24个月：t＝0.455，P＝0.656）。第1组和第2组术前、术后平均使用抗青光眼药物数量分别为（2.4±1.7），（0.9±1.4）；（3.0±1.2），（0.1±0.5）种，房水流出通路重建术组较Schlemm管成形术组术后平均使用抗青光眼药物数量减少，差异有统计学意义（t ＝2.180， P＝0.041）。房水流出通路重建术组2例（2/14）术后发生前房出血明显低于Schlemm管成形术组（11/17）。结论房水流出通路重建术对开角型青光眼患者的短期降低眼压效果与Schlemm管成形术类似，并发症发生率较Schlemm管成形术低，是一种安全有效的手术方式，但其远期效果有待进一步观察。

abstractsObjective To compare the safety and efficacy between canaloplasty and aqueous drainage pathway reconstruction surgery in patients with open-angle glaucoma ( OAG).Methods It is a retrospective case series study.Thirty-one eyes (25 patients) with OAG were divided into canaloplasty (n=17;54.8%) group or aqueous drainage pathway reconstruction ( n=14;45.2%) group.The intraocular pressure ( IOP ) , numbers of IOP-lowering medications and incidence of complications were recorded at 1 day, 1 week, 1, 3, 6 and 12 months after the operation.Independent-samples T test was used to compare the IOP, numbers of IOP-lowering medications before and 1, 3, 6, 12, 24 months after surgery between two groups.Kaplan-Meier Survival Analysis was used to analyze the success rate of these two surgical methods.Log rank test was used to compare the difference of cumulative success rate at 6, 12 months after surgery.Results The mean IOP values were (24.7 ±8.7), (14.5 ±2.5), (14.9 ±2.5), (14.9 ±2.5), (14.7 ±2.1) and (15.4 ±2.3)mmHg (1 mmHg=0.133 kPa) in canaloplasty group at before surgery , 1, 3, 6, 12 and 24 months after surgery.The same values were (28.5 ±10.6), (14.3 ±3.6), (14.2 ±3.2), (14.3 ±&nbsp;3.6), (15.9 ±3.2) and (14.6 ±0.7)mmHg in aqueous drainage pathway reconstruction group.There was no difference in the extent of IOP reduction between these two groups ( preoperative: t =-1.1014, P=0.278;postoperative 1 month:t=0.696,P=0.492;3 month:t=0.594,P=0.557;6 month:t=0.536, P=0.596;12 month:t=-1.127, P=0.273;24 month:t=0.455, P=0.656).There were significant differences ( P<0.01) in post-surgery IOP lowering medication usage between these two groups , while pre-surgery medication usage were similar.The incidence of hyphema was significantly lower in aqueous drainage pathway reconstruction surgery group ( 2 eyes ) than that in canaloplasty group ( 11 eyes ).Conclusions Both canaloplasty and aqueous drainage pathway reconstruction could reduce IOP effectively for open -angle glaucoma.The incidence of complication was lower in the aqueous drainage pathway reconstruction group than canaloplasty group.However, long-term efficacy between these two groups is yet to be determined.