難治性(xing)(xing)(xing)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)一(yi)般是(shi)指那些(xie)藥(yao)(yao)物難以(yi)(yi)控(kong)制眼(yan)(yan)壓(ya)，而做常規手(shou)術(shu)(shu)效果又不好(hao)的(de)(de)(de)(de)(de)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)，如(ru)既(ji)往(wang)濾(lv)過性(xing)(xing)(xing)手(shou)術(shu)(shu)失敗的(de)(de)(de)(de)(de)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)、青(qing)(qing)(qing)少年(nian)型青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)、無晶體性(xing)(xing)(xing)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)、有(you)(you)較長用藥(yao)(yao)歷史的(de)(de)(de)(de)(de)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)、新生(sheng)(sheng)血(xue)(xue)管(guan)性(xing)(xing)(xing)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)以(yi)(yi)及某些(xie)繼發(fa)性(xing)(xing)(xing)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)等(deng)。這(zhe)些(xie)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)之所以(yi)(yi)難治，是(shi)因(yin)為存在以(yi)(yi)下(xia)復雜因(yin)素;多(duo)次手(shou)術(shu)(shu)失敗的(de)(de)(de)(de)(de)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)患者(zhe)可能屬于對創(chuang)(chuang)傷(shang)有(you)(you)超強(qiang)愈(yu)合反應(ying)的(de)(de)(de)(de)(de)個體;青(qing)(qing)(qing)少年(nian)多(duo)具有(you)(you)肥厚的(de)(de)(de)(de)(de)眼(yan)(yan)球筋(jin)膜(mo)(mo)和活(huo)躍的(de)(de)(de)(de)(de)創(chuang)(chuang)傷(shang)愈(yu)合反應(ying);無晶體性(xing)(xing)(xing)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)的(de)(de)(de)(de)(de)玻璃體可釋放一(yi)種成(cheng)纖(xian)維細(xi)(xi)胞刺激(ji)素，促使瘢痕形(xing)成(cheng);新生(sheng)(sheng)血(xue)(xue)管(guan)性(xing)(xing)(xing)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)術(shu)(shu)后(hou)(hou)濾(lv)過道(dao)常有(you)(you)新生(sheng)(sheng)血(xue)(xue)管(guan)及血(xue)(xue)管(guan)性(xing)(xing)(xing)結締(di)組織膜(mo)(mo)生(sheng)(sheng)長，使其堵塞(sai);炎(yan)癥尚未(wei)控(kong)制的(de)(de)(de)(de)(de)血(xue)(xue)管(guan)膜(mo)(mo)炎(yan)(葡萄膜(mo)(mo)炎(yan))繼發(fa)性(xing)(xing)(xing)青(qing)(qing)(qing)光(guang)(guang)(guang)眼(yan)(yan)，手(shou)術(shu)(shu)后(hou)(hou)組織反應(ying)強(qiang)烈，血(xue)(xue)-房水屏障(zhang)破壞，纖(xian)維連(lian)接蛋白和生(sheng)(sheng)長因(yin)子釋放并激(ji)活(huo)成(cheng)纖(xian)維細(xi)(xi)胞增(zeng)生(sheng)(sheng)，使濾(lv)過道(dao)瘢痕化。
為了提高難治(zhi)性青光(guang)眼(yan)(yan)的手術(shu)成(cheng)(cheng)功率(lv)，可在(zai)術(shu)中或術(shu)后(hou)應用抗代謝(xie)藥如絲裂霉素、氟尿嘧啶，以抑制成(cheng)(cheng)纖(xian)維細胞的增(zeng)殖;也(ye)可采用房(fang)水引流裝置(zhi)(zhi)(zhi)，如Molteno裝置(zhi)(zhi)(zhi)，由一(yi)(yi)硅膠(jiao)管(guan)將房(fang)水引流至安置(zhi)(zhi)(zhi)于眼(yan)(yan)球后(hou)方(fang)得(de)盤片(pian)下形成(cheng)(cheng)一(yi)(yi)個“房(fang)水蓄水池”，后(hou)房(fang)水擴散至眼(yan)(yan)球后(hou)部組(zu)織(zhi)并被毛細血(xue)管(guan)和淋巴管(guan)吸收。近(jin)年來又(you)有改良房(fang)水引流裝置(zhi)(zhi)(zhi)，如Krupin閥(fa)門、Amehd閥(fa)門投入臨床應用。改良房(fang)水引流裝置(zhi)(zhi)(zhi)的內部設(she)計得(de)有一(yi)(yi)壓(ya)(ya)力敏(min)感開關，閥(fa)門開放壓(ya)(ya)力一(yi)(yi)般(ban)為2.13kPa(16mmHg)，關閉(bi)壓(ya)(ya)力為1.60kPa(12mmHg)。在(zai)理(li)論上，當(dang)眼(yan)(yan)壓(ya)(ya)高于2.13kPa時，閥(fa)門開啟(qi)，房(fang)水向眼(yan)(yan)外(wai)引流，使眼(yan)(yan)壓(ya)(ya)下降;當(dang)眼(yan)(yan)壓(ya)(ya)低于1.60kPa時，閥(fa)門關閉(bi)，眼(yan)(yan)壓(ya)(ya)不(bu)致(zhi)降得(de)太(tai)低。