方法：采集2014-03/2016-03我院收治的高度近视硬核(Ⅳ～Ⅴ级核)白内障患者297例322眼作为研究对象，随机分为观察组(给予囊膜上超声乳化治疗149例162眼)和对照组(给予囊袋内超声乳化治疗148例160眼)。对两组患者治疗效果及安全性进行比较。

结果：核硬度越高，超声乳化时间及平均超声能量越高，差异有统计学意义(P<0.05)，观察组超声乳化时间及能量参数明显低于对照组，差异有统计学意义(P<0.05)； 两组患者术后1mo 视力均较术后1d明显提高，差异有统计学意义(P<0.05)，两组间比较差异无统计学意义(P>0.05)； 两组患者术后角膜内皮细胞密度较术前显著降低，差异有统计学意义(P<0.05)，组间比较差异无统计学意义(P>0.05)； 观察组术中并发症发生率明显低于对照组，差异有统计学意义(P<0.05)，两组术后并发症发生率相比，差异无统计学意义(P>0.05)。

结论：囊膜上超声乳化与囊袋内超声乳化治疗高度近视硬核白内障疗效接近，但囊膜上超声乳化具有更佳的安全性。

METHODS: A total of 297 patients(322 eyes)with hard nucleus cataract(Ⅳ-Ⅴ grade nucleus)and high myopia were selected from Mar.2014 to Mar.2016 in our hospital. They were randomly divided into the observation group with 149 cases(162 eyes)and the control group with 148 cases(160 eyes). The observation group received capsule membrane phacoemulsification and the control group received capsular bag in phacoemulsification. The therapeutic effect and safety of patients in two groups were compared. The comparison of phacoemulsification time, energy parameters and corneal endothelial cell density used t-test, post-operative visual acuity and the occurrence of complications were tested by Chi-square test.

RESULTS: The harder the nucleus was, the longer the phacoemulsification time and higher the average phacoemulsification energy was, and the differences were statistically significant(P<0.05). The phacoemulsification time and energy parameters of the observation group were significantly lower than that of the control group(P<0.05). One month after operation, the postoperative visual acuity in two groups was significantly higher than the visual acuity at 1d after operation(P<0.05). But there was no statistical significance on the visual acuity at 1mo after operation between two groups(P>0.05). After operation, the density of corneal endothelial cell in two groups was significantly lower than the density before operation(P<0.05). But there was no statistical significance on the density of corneal endothelial cell after operation between two groups(P>0.05). The intraoperative complication rate of observation group was significantly lower than that of the control group(P<0.05), but there was no statistical significance on postoperative complication rate between two groups(P>0.05).

CONCLUSION: For the treatment of hard nuclear cataract with high myopia, capsule membrane phacoemulsification and capsular bag in phacoemulsification have similar effect, but capsule membrane phacoemulsification has better safety.