To investigate the effect of compound trabeculectomy combined with adjustable suture in the treatment of glaucoma. Methods A total of 65 patients with glaucoma admitted to our hospital from January 2019 to December 2022 were randomly divided into control group (n =33) and observation group (n =32). The control group was treated with trabeculectomy, and the observation group was treated with compound trabeculectomy combined with adjustable suture. The clinical efficacy, intraocular pressure and complications were compared between the two groups. Results The total effective rate of treatment in the observation group was 93.75%, which was higher than 75.76% in the control group (P <0.05). The intraocular pressure of the two groups at 3 months after operation was better than that before operation, and the observation group was better than the control group (P <0.05). The incidence of complications in the observation group was 3.13%, which was lower than 21.21% in the control group (P <0.05). Conclusion Compound trabeculectomy combined with adjustable suture has a good clinical effect in the treatment of glaucoma, which can effectively stabilize the intraocular pressure, improve vision, and reduce the risk of complications, with higher application safety.