方法：白内障手术患者按眼轴长度分为正常眼轴组(22mm≤AL<24mm组)、中长眼轴组(24mm≤AL<26mm)及长眼轴组(AL≥26mm)，每组各100眼。每组中各有50眼随机接受FLACS及PHACO手术方案。术前及术后3mo行BCVA、视觉质量及角膜内皮细胞计数检查，并对结果进行统计学分析。

结果：各组患者术后视力较术前均有提高(P<0.01)，不同眼轴组FLACS术后视力提升较PHACO术后好， 但组间均无差异(P>0.05)。PHACO组除中长眼轴组外其他各组患眼术后strehl ratio值均较术前提高，但仅正常眼轴组的斯特列尔比(strehl ratio)增加有统计学意义(P<0.05)。各眼轴组内FLACS组与PHACO组比较，strehl ratio值变化均无差异(P>0.05)。FLACS组术后角膜内皮计数均较术前减少(P<0.01)； PHACO组除中长眼轴组外术后角膜内皮计数均较术前减少(P<0.01)； FLACS与PHACO组间术后角膜内皮计数均无差异(P>0.05)。

结论：飞秒激光辅助白内障手术比传统超声乳化手术能有效提高不同眼轴长度的白内障患眼术后BCVA以及术后视觉质量，两种手术方式均会对角膜内皮造成损伤，但无差异。

METHODS: Patients with cataract surgery were divided into normal axis group(22mm≤AL<24mm group), medium and long axis group(24mm≤AL <26mm), and long axis group(26mm≤AL)according to the axial length. Each group had 100 eyes. The patients in each group were randomly divided into femtosecond laser group and traditional ultrasonography group. The postoperative changes of best-corrected visual acuity(BCVA), visual quality and corneal endothelial cells were analyzed.

RESULTS: The visual acuity of the patients in each group was improved(FLACS: t=8.29, 25.01, 19.23, all P<0.01; PHACO: t=19.61, 18.76, 18.23, all P<0.01). Visual acuity improvement after FLACS in different axial groups was better than that after PHACO, but there was no significant difference between the groups(P=0.24, 0.25, 0.19). The postoperative strehl ratio value increased after operation in all groups expect for PHACO medium and long axis group, but the increase was significant only in normal axis group(P=0.011, 0.007). The corneal endothelial counts in the FLACS group were significantly lower than those before the operation(P<0.01, 0.002, <0.01). The corneal endothelial counts in the PHACO group except for the medium and long axis group were significantly reduced after surgery(P<0.01); there was no significant difference in postoperative corneal endothelial count between the FLACS and PHACO groups(P>0.05).

CONCLUSION: Both traditional cataract surgery and femtosecond laser-assisted cataract surgery can effectively improve the BCVA in various types of axis. Both surgical methods will cause damage to the corneal endothelium, but the difference is not obvious.