摘要：目的：探究同轴微切口超声乳化联合人工晶状体植入术对老年性白内障患者视力恢复及安全性的影响。方法：选取2022年12月至2023年12月在本院就诊的的老年性白内障患者98例（98只眼）作为研究对象，依据手术方式的不同分为对照组和观察组，各49例。对照组接受3.0mm标准切口超声乳化联合人工晶状体植入术治疗，观察组接受2.2mm同轴微切口超声乳化联合人工晶状体植入术治疗。比较两组术前、术后1d、术后1周、术后1个月、术后3个月各时段最佳矫正视力（BCVA）、角膜散光以及角膜内皮细胞各指标的差异，并统计患者术后并发症的发生情况，评价治疗的安全性。结果：与术前比较，两组术后1d、术后1周、1个月、3个月的BCVA均降低（P＜0.05），且观察组患者术后1d、术后1周、1个月、3个月的BCVA均低于对照组（P＜0.05）。与术前比较，两组术后1d、术后1周、1个月、3个月的角膜散光均升高（P＜0.05），且观察组患者术后1d、术后1周、1个月、3个月的角膜散光均高于对照组（P＜0.05）。与术前比较，两组患者术后3个月的角膜细胞密度、六角细胞比例均降低，角膜内皮细胞变异系数升高（P＜0.05），但两组术后上述指标比较，无统计学差异（P＞0.05）。两组术后并发症发生率分别为8.16%（4/49）和4.08%（2/49），比较无统计学差异（P＞0.05）。结论：同轴微切口超声乳化联合人工晶状体植入术能显著促进老年性白内障患者的视力恢复，矫正术前角膜散光，较为安全。

Abstract: Objective: To investigate the effects of coaxial microincision phacoemulsification combined with intraocular lens implantation on visual recovery and safety of senile cataract patients. Methods: A total of 98 patients (98 eyes) with senile cataract treated in our hospital from December 2022 to December 2023 were selected as the study objects, and were divided into control group and observation group according to different surgical methods, with 49 cases in each group. The control group received 3.0mm standard incision phacoemulsification combined with intraocular lens implantation, and the observation group received 2.2mm coaxial micro-incision phacoemulsification combined with intraocular lens implantation. The best corrected visual acuity (BCVA), corneal astigmatism and corneal endothelial cell indexes were compared between the two groups before surgery, 1 day after surgery, 1 week after surgery, 1 month after surgery, and 3 months after surgery. The incidence of postoperative complications was analyzed to evaluate the safety of treatment. Results: Compared with pre-operation, BCVA in both groups decreased at 1d, 1 week, 1 month and 3 months after surgery (P < 0.05), and BCVA in observation group was lower than that in control group at 1d, 1 week, 1 month and 3 months after surgery (P < 0.05). Compared with the preoperative results, the corneal astigmatism of the two groups was increased 1 day, 1 week, 1 month and 3 months after surgery (P < 0.05), and the corneal astigmatism of the observation group was higher than that of the control group 1 day, 1 week, 1 month and 3 months after surgery (P < 0.05). Compared with the preoperative results, the corneal cell density and the proportion of hexagonal cells were decreased, and the coefficient of variation of corneal endothelial cells was increased (P < 0.05), but there was no statistical difference in the above indexes between the two groups after surgery (P > 0.05). The incidence of postoperative complications was 8.16% (4/49) and 4.08% (2/49), and there was no significant difference between the two groups (P > 0.05). Conclusion: Coaxial micro-incision phacoemulsification combined with intraocular lens implantation can significantly promote the visual recovery of senile cataract patients and correct preoperative corneal astigmatism, which is relatively safe.

2021 年成都市医学科研课题（2021300）