方法：对老年性白内障Ⅳ级以上硬核患者随机分成两组，观察组30例30眼采用巩膜隧道切口拦截劈裂法联合手法娩核，对照组20例20眼采用常规超声乳化碎核，两组均联合后房型折叠人工晶状体植入。对比两组术中核处理时间、并发症、术后视力、角膜水肿情况、眼压及角膜内皮细胞数量变化等。

结果：观察组和对照组术中核处理时间分别是60±10，90±15s(P<0.05)； 观察组手术并发症如后囊膜破裂发生率、角膜水肿反应和角膜内皮损伤均比对照组低，差异具有统计学意义(P<0.05)； 两组术后视力、眼压无显著性差异。

结论：拦截劈裂法联合手法娩核具有核处理时间短、视力恢复快、并发症少的特点，是治疗Ⅳ级以上硬核白内障较理想的选择之一。

METHODS: Totally 50 cases(50 eyes)of age-related cataract with above IV grade hard nucleus were randomly divided into two groups, 30 cases(30 eyes)were in observe group which was performed by stopping and chopping method combined with manual nucleus extraction and 20 cases(20 eyes)underwent phacoemulsification as control group, intraocular lenses implantation was performed in two groups. The processing time of nucleus, operative complications, postoperative visual acuity, the condition of corneal edema, intraocular pressure and corneal endothelial cells were observed.

RESULTS: The processing time of nucleus of observe group and control group was 60±10s, 90±15s, respectively(P<0.05). Operative complications of the observe group, which were the incidence of posterior capsular rupture, the reaction of corneal edema and the damage of corneal endothelial cells, was less than control group and no statistical significance(P<0.05). The difference of postoperative visual acuity and intraocular pressure was not obvious in two groups.

CONCLUSION: Stopping and chopping method combined with manual nucleus extraction in hard nucleus cataract has many virtues of security, faster visual recovery and less complications.It is one of the ideal treatment of age-related cataract with above IV grade hard nucleus.