方法： 选取2015-04/2016-08 于我院行白内障超声乳化手术(核硬度Ⅲ～Ⅳ级)126 例 158 眼，随机分为预劈核组(A组)58 例 76 眼和传统乳化组(B组)68 例 82 眼。A组在进行超声乳化核处理前先进行针刺预劈核。分别记录术中平均超声能量(AP)、实际超声乳化时间(U/S time)、累积能量复合参数(AECP)、术中并发症，以及术前和术后平均角膜内皮细胞密度、平均角膜内皮细胞丢失率、裸眼视力和角膜水肿等情况，并进行组间比较。

结果：A组的 AP，U/Stime，AECP 均低于B组，差异有统计学意义(P<0.05)； 术后1d，Ⅳ级核A组角膜水肿轻于B组，裸眼视力Ⅳ级核预劈核组也优于传统超乳组，差异有统计学意义(P<0.05)，而术后 1wk裸眼视力组间比较无统计学意义(P>0.05)。术后 1wk， B组平均角膜内皮细胞密度均低于A组，角膜内皮细胞丢失率高于A组，差异有统计学意义(P<0.05)。术中出现晶状体后囊膜破裂 A 组 2 眼，B 组有4 眼。

结论： 与传统乳化劈核相比，针刺预劈核联合乳化劈核术中超声时间更短、能量更低、术后角膜内皮细胞丢失更少、术后早期裸眼视力更好。

METHODS: One hundred and twenty-six patients(158 eyes)of age-related cataracts with nucleus density at grade Ⅲ-Ⅳ were randomly divided into two groups. Group A was performed a manual prechop technique using a surgeon-bent cystotome after the capsulorhexis, while group B was performed traditional phaco-chop without prechop technique. The average power(AP), actual ultrasonic time(U/S time), accumulated energy complex parameter(AECP)of machine, average density of endothelial cells, endothelial cells loss, uncorrected visual acuity(UCVA), corneal edema and intraoperative complications were compared between groups.

RESULTS: The AP, U/S time and AECP of Group A were significantly lower than that of Group B(P<0.05). At postoperative day 1, the corneal edema of Group A was slighter than the control with significant difference(P<0.05), so was the UCVA. While there was no significant difference of UCVA between groups at postoperative 1wk. The average corneal endothelium density of Group B was significantly lower than that of Group A at postoperative 1wk, and the average cell loss was higher than that of Group A. Two eyes of group A had posterior capsular rupture compared to 4 eyes of Group B.

CONCLUSION: Compared with traditional phaco-chop, the cystotome-assisted prechop technique presents shorter intraoperative ultrasound time and lower energy, while contributes to less corneal endothelial cell loss and better early postoperative UCVA.