目的：观察1.8mm透明角膜切口白内障超声乳化联合超薄人工晶状体植入术治疗短眼轴白内障的临床疗效，并与传统的3.0mm透明角膜切口超声乳化手术进行比较。

方法：前瞻性随机对照研究。将84例84眼平均眼轴长20.26±1.59mm(眼轴范围17.68～21.32mm)的年龄相关性白内障患者随机分为两组，分别行1.8mm同轴微切口白内障超声乳化吸除联合人工晶状体植入术和3.0mm同轴小切口白内障超声乳化吸除联合人工晶状体植入术。术中记录两组患者超声乳化所用的有效超声时间(EPT)和平均超声能量(AVE)，术后随访1d，1wk，1、3mo，观察两组术后最佳矫正视力、眼压、中央前房深度、角膜内皮细胞密度、手术源性散光和手术并发症情况。

结果：A、B两组患者术中EPT分别为6.88±3.05、7.04±3.57s，术中AVE分别为(14.54±7.26)%和(15.08±3.67)%。术后1d，1wk，1、3mo微切口组手术源性散光低于小切口组，差异具有统计学意义(P<0.05)。两组间最佳矫正视力及角膜内皮细胞密度无显著性差异。两组患者术后眼压均较术前明显下降，术后前房深度均较术前明显加深。所有患者术中前房稳定，术中及术后无并发症发生，均无切口热烧伤。

结论：同轴1.8mm微切口与传统的同轴3.0mm小切口超声乳化手术治疗短眼轴白内障相比，能有效地减少手术源性散光，可显著改善早期视功能。

AIM:To observe the clinical effect of 1.8mm clear corneal incision phacoemulsification with ultra-thin intraocular lenses(IOLs)implantation for the treatment of short eye axis cataract, and to compare with the 3.0mm traditional clear corneal incision phacoemulsification.

METHODS:A prospective randomized study. Eighty-four cases(84 eyes)with short eye axis were selected. Ocular axis ranged 17.68～21.32mm(the average axis was 20.26±1.59mm). The cases with age-related cataract were randomly divided into two groups. Micro incision group(group A):1.8mm coaxial micro-incision phacoemulsification with ultra-thin IOLs implantation; Small incision group(group B):3.0mm coaxial small incision phacoemulsification with IOLs implantation. The effective phaco time(EPT)and the mean intraoperative ultrasound energy(AVE)were recorded. The postoperative best corrected visual acuity, intraocular pressure(IOP), central anterior chamber depth, corneal endothelial cell density, surgically induced astigmatism and operation complications were observed. All cases were followed up at 1d, 1wk, 1 and 3mo.

RESULTS:The EPT of group A and group B were 6.88±3.05, 7.04±3.57s respectively, the AVE were(14.54±7.26)% and(15.08±3.67)%. The EPT and AVE had no statistically significant difference between the two groups. At postoperative 1d, 1wk, 1 and 3mo, surgically induced astigmatism of group A was lower than that of group B and there was a significant difference between the two groups(P<0.05). The best corrected visual acuity and corneal endothelial cell density had no significant difference between the two groups. Postoperative intraocular pressure was significantly decreased in two groups and postoperative anterior chamber depth was significant deepen. Anterior chamber kept stable in all patients, no complications and no incision thermal burn were found during the operation.

CONCLUSION:The 1.8mm coaxial micro-incision can effectively reduce the astigmatism,and significantly improve the early visual function for treatment of short eye axis cataract compared to traditional 3.0mm coaxial small incision phacoemulsification.

内蒙古自治区科技厅科研基金(No.20130409)