方法：选取我院白内障患者60例62眼，均采用透明角膜切口，切口分别位于最大角膜屈光力子午线轴位(A组)、传统颞上侧(右眼)或鼻上侧(左眼)(B组)。两组同时行白内障超声乳化吸除术和可折叠式人工晶状体植入术。分别在术前，术后1d，1wk，1mo用CT200角膜地形图仪进行测量。根据角膜散光度和轴向计算手术源性散光度。分别比较两组患者的角膜散光度、手术源性散光度和裸眼视力。

结果：术前两组患者年龄、性别、晶状体核硬度、视力、角膜散光度比较差异无统计学意义(P>0.05)。术后各组的视力均比术前提高，差异有统计学意义(P<0.05)，但术后1d，1wk，1mo两组患者的视力比较差异均无统计学意义(P>0.05)。术后1d两组患者角膜散光度比较差异无统计学意义(P>0.05)； 在术后1wk，1mo A组患者的角膜散光度均显著小于B组，差异具有统计学意义(P<0.05)。术后1wk，1mo，A组患者手术源性散光度矢量分析均显著小于B组，差异具有统计学意义(P<0.05)。

结论：选择角膜最大曲率方向作为在白内障手术中的透明角膜切口，能让白内障患者在手术后的角膜散光度和手术源性散光度降低。

METHODS: Totally 60 cases(62 eyes)of cataract patients were selected from our hospital, divided into Group A and Group B randomly. Two groups were both required to have a corneal incision, while Group A took it in the maximum corneal refractive radial axial and the Group B took it in the traditional temporal side(right eye)or nasal side(left eye). At the same time two groups received phacoemulsification and foldable intralocular lens(IOL)implantation. We measured their date before surgery, after surgery in 1d, 1wk and 1mo respectively with CT200 corneal topography measurement. The date was compared in two groups of corneal astigmatism, surgically induced astigmatism and visual acuity. According to the corneal astigmatism and axial, surgically induced astigmatism was calculated.

RESULTS: Group A and Group B were compared in age, gender, lens nucleus hardness, visual acuity, corneal astigmatism before the surgery, which has no statistically significant differences(P>0.05). Postoperative visual acuity of both groups was higher than preoperative(P<0.05), but the difference was not statistically significant in 1d, 1wk and 1mo after surgery in two groups(P>0.05). Corneal astigmatism was not statistically significant in two groups at 1d after surgery(P>0.05). The corneal astigmatism was significantly less in Group A than that in Group B in 1wk and 1mo after surgery, and the difference was statistically significant(P<0.05). After the surgery for 1wk and 1mo, the surgically induced astigmatism of Group B was significantly higher than that of the Group A, with the difference was statistically significant(P<0.05).

CONCLUSION: Making clear corneal incision along the maximum curvature of the cornea in cataract surgery can make the corneal astigmatism and the degree of astigmatism less after surgery.