目的：探究小切口水平空间劈核术联合区域折射型多焦点人工晶状体（MIOL）植入治疗硬核年龄相关性白内障的临床疗效。方法：选择288例于2022年1月至2023年12月至本院进行年龄相关性白内障治疗的患者，随机数字表法分为对照组（采用超声乳化+区域折射型MIOL进行治疗）、观察组（采用小切口水平空间劈核术+区域折射型MIOL进行治疗）各144例，比较两组患者的最佳矫正视力、散光和内皮情况、泪膜功能、并发症。结果：观察组术后3个月时的最佳矫正视力明显高于对照组（P＜0.05）；两组角膜散光值和中央角膜厚度均呈现先升高后降低的趋势，内皮细胞密度呈现先降低后升高趋势，两组手术前后角膜散光值和中央角膜厚度比较组间、时间、交互差异均有统计学意义（P＜0.05），内皮细胞密度组间比较有统计学意义（P＜0.05）；两组BUT呈现先降低后升高趋势，OSDI呈现先升高后降低趋势，两组组间、时间、交互差异均存在统计学意义（P＜0.05）；观察组并发症发生率（4.17%）明显低于对照组（18.06%）（P＜0.05）。结论：小切口水平空间劈核术联合区域折射型MIOL植入能够有效提高硬核年龄相关性白内障患者的最佳矫正视力，改善患者散光和内皮情况，增强患者的泪膜功能，减少并发症发生。

Objective: To explore the clinical efficacy of small-incision horizontal space nuclear splitting combined with regional refractive multifocal intraocular lens (MIOL) implantation in the treating age-related hard nucleus cataracts. Methods: From January 2022 to December 2023, 288 patients who underwent age-related cataract treatment at our hospital were randomly separated into a control group (treated with phacoemulsification and regional refractive MIOL) and an observation group (treated with small incision horizontal space nuclear splitting and regional refractive MIOL), with 144 patients in each group. The best corrected visual acuity, astigmatism and endothelial condition, tear film function, and complications of the two groups were compared. Results: The best corrected visual acuity of the observation group was obviously higher than that of the control group at 3 months after surgery (P<0.05). The corneal astigmatism value and central corneal thickness of the two groups showed a trend of first increasing and then decreasing, while the endothelial cell density showed a trend of first decreasing and then increasing. The differences in corneal astigmatism value and central corneal thickness among groups, time were statistically obvious (P<0.05), while the comparison of endothelial cell density between the two groups was statistically obvious (P<0.05). The BUT of the two groups showed a trend of first decreasing and then increasing, while OSDI showed a trend of first increasing and then decreasing, there were statistically obvious differences among groups and time (P<0.05). The incidence of complications in the observation group (4.17%) was obviously lower than that in the control group (18.06%) (P<0.05). Conclusion: Small incision horizontal space nuclear splitting combined with regional refractive MIOL implantation can effectively improve the best corrected visual acuity of patients with age-related hard nucleus cataracts, improve astigmatism and endothelial condition, enhance tear film function, and reduce the occurrence of complications.