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目的:评价小梁切除联合Schlemm管外壁切除术治疗晚期青少年型青光眼的效果。方法:回顾性研究。收集2018年10月至2020年2月就诊于郑州大学第一附属院眼三科晚期青少年型青光眼40例(66眼)的临床资料。患者分成两组：A组，19例(33眼)，接受小梁切除联合Schlemm管外壁切除术；B组，21例(33眼)，接受小梁切除手术。随访12个月，对比两组手术前后视力、眼压视野及视神经纤维层厚度。结果:术后12个月，两组视力、平均视野缺损值(MD)及视网膜神经纤维层(RNFL)厚度分别与术前相比差异均无统计学意义(n P>0.05)。两组术后各随访时间点眼压均较术前下降(n P<0.05)。术后1周、1、3、6及12个月眼压A组低于B组(n P0.05). The intraocular pressure at each follow-up time point after operation in the two groups were lower than that before operation, and the difference were statistically significant (n P<0.05). The IOP in group A was lower than that in group B at every follow-up time point. There were significant differences in intraocular pressure between the two groups at 1 week, 1, 3, 6 and 12 months after operation (n P<0.05). There were no severe complication such as suprachoroidal hemorrhage, hypotension macular edema or endophthalmitis in both groups during and after operation.n Conclusion:Trabeculectomy combined with resection of external wall of Schlemm’s canal for the treatment of advanced juvenile glaucoma can effectively control the intraocular pressure and protect visual function.