Objective To evaluate the efficacy and safety of Ahmed glaucoma valve implantation versus trabeculectomy in the treatment of refractory glaucoma after scleral buckling.Methods A total of 41 eyes of 41 patients with glaucoma after scleral buckling who accepted Ahmed glaucoma valve implantation or trabeculectomy were enrolled,including 19 patients in the valve group and 22 patients in the trabeculectomy group.The successful rate,intraocular pressure (IOP) reduction,visual acuity,complications and medical therapy were observed for one year.Results The successful rate was 63.16％ in the valve group 12 months after surgery,and 31.82％ in the trabeculectomy group.The success rate in the valve group was significantly higher than that in the trabeculectomy group at 12 months follow-up (x2 =4.027,P =0.0427).IOP decreased from (24.7±2.8) mmHg at baseline to (16.5 ±4.9) mmHg in the valve group 12 months after surgery,and it decreased from (25.5 ± 3.6) mmHg to (19.8 ± 4.3) mmHg in the trabeculectomy group.The IOP in the valve group was significantly lower than that in the trabeculectomy group at 12 months followup (t =2.1102,P =0.0427).There was no significant difference in visual acuity,complications or medical therapy between those two groups.Conclusion Compared with trabeculectomy,Ahmed glaucoma valve implantation is an option with more persistence and same security in the treatment of glaucoma after scleral buckling.