目的 :研究非穿透性小梁切除术治疗开角型青光眼的手术效果、手术并发症及可能的降压机制。病人和方法 :男性 2 7例 ,女性 13例 ,共 40例 5 3眼。平均年龄 41.87± 2 0 .92岁。其中原发性开角型青光眼 2 4例 (32眼 )、先天性青光眼 5例 (8眼 )、皮质类固醇性青光眼 4例 (6眼 )、外伤性青光眼 7例 (7眼 )。手术在上方角巩膜缘做双层巩膜瓣 ,第二层巩膜瓣的深度为略暴露出点状葡萄膜组织 ,并向透明角膜区分离出 1～ 2 mm后弹力层 ,房水通过后弹力层渗出。剪除第二层巩膜瓣 ,手术不进入前房 ,术毕在巩膜瓣下注入透明质酸钠。术后观察病人前房反应、眼压及结膜滤枕情况。随访时间 3～ 18个月。结果 :术中 8眼穿破小梁 -后弹力膜 ,术后前房反应轻 ,6眼发生前房出血 ,1眼出现羊脂状角膜后沉淀。 17眼结膜形成滤过手术典型滤过泡 ,36眼结膜疏松 ,无滤过泡形成。各种青光眼的术后降压幅度较术前分别降低 32 .4～ 5 2 .8%。结论 :非穿透性小梁切除术能很好的降低开角型青光眼病人的眼压。因术后并发症轻、少 ,可做为门诊青光眼病人和高危青光眼病人手术的选择。后巩膜葡萄膜的房水引流机制可能是该术式降压的机制之一 Objective: To study the operative effect, operative complications and possible antihypertensive mechanism of non-penetrating trabeculectomy for open-angle glaucoma. Patients and methods: 27 males and 13 females, a total of 40 cases 53 eyes. The average age was 41.87 ± 20.92 years old. There were 24 cases of primary open-angle glaucoma (32 eyes), 5 cases of congenital glaucoma (8 eyes), 4 corticosteroid glaucoma (6 eyes) and 7 traumatic glaucoma (7 eyes). Surgery in the upper scleral margin to do double scleral flap, the depth of the second scleral flap slightly exposed punctiform uveal tissue, and to the transparent corneal area after the separation of 1 ~ 2 mm elastic layer, aqueous humor through the elastic layer Exudation. Cut off the second layer of scleral flap, the surgery does not enter the anterior chamber, surgery under scleral flap injection of sodium hyaluronate. Postoperative observation of patients with anterior chamber reaction, intraocular pressure and conjunctival filter case. Follow-up time of 3 to 18 months. Results: 8 eyes penetrated the trabecular-posterior elastic membrane, the anterior chamber reaction was mild, 6 cases had anterior chamber hemorrhage, and 1 appeared supine goiter. 17 conjunctiva formation filtration surgery typical filtration bleb, 36 conjunctiva loose, no filtration through the formation of bubbles. Various types of glaucoma postoperative antihypertensive rate decreased compared with preoperative 32.4 ~ 52.8%. Conclusion: Non-penetrating trabeculectomy can reduce the intraocular pressure in patients with open-angle glaucoma. Due to postoperative complications light, less, can be used as outpatient glaucoma patients and high-risk glaucoma surgery options. Posterior scleral uveal aqueous humor drainage mechanism may be one of the mechanisms of antihypertensive surgery