方法：对324例324眼老年性白内障患者，随机分成三组，分别通过注水圈套器娩核法、水压娩核法和前房内劈核法完成娩核过程，观察记录娩核时间、术中并发症、术后第1d角膜内皮水肿程度及术后视力，观察结果行统计学处理。

结果：娩核时间：注水圈套器娩核法平均时间45s、水压娩核法平均时间34s和前房内劈核法平均时间65s，三组的平均娩核时间均存在统计学差异(P<0.05)。注水圈套器娩核法和前房内劈核法的并发症主要表现为虹膜损伤和后囊膜破裂； 水压娩核法则主要表现为前房出血。统计学分析，角膜水肿0～1级者：A组与B组、B组与C组均有显著性差异(P<0.05)，A组与C组统计学处理无显著性差异(P>0.05)。术后1d视力：A组与C组、B组与C组均有显著性差异(P<0.05)，术后7d视力：只有B组与C组有显著性差异(P<0.05)，术后1mo视力：三组间无显著差异(P>0.05)。

结论：前房内劈核法对Ⅳ级以上核的处理优势是明显的； 水压娩核法术中并发症少，术后第1d角膜内皮水肿发生率低，更适用于Ⅳ级以下的核娩出。

METHODS:There were 324 cases(324 eyes)with senile cataract randomly divided into three groups, by the lens loop extracting nucleus method(group A), water irrigation(group B)and nucleus fragmentation within anterior chamber(group C), to complete the process of nucleus division. The time of nuclear removal, complication during operation, the degree of edema of corneal endothelium on the first day after the surgery and visual acuity after surgery were observed and recorded.

RESULTS:The average extracting nucleus time was 45s in lens loop(group A); 34s in water irrigation(group B)and 65s in manual fragmentation(group C).The differences of average time are statistically significant(P<0.05), and the complications in lens loop and manual fragmentation mainly are iris trauma and posterior capsular rupture; the complication in the water irrigation is hyphema. Regarding corneal edema from 0 to 1degree, the difference between group A and group B, group B and group C were statistically significant(P<0.05). The difference between group A and group C had no statistical significance(P>0.05).Regarding the visual acuity on the first day after surgery, the difference between group A and group C, group B and group C were statistically significant(P<0.05), The visual acuity on the 7th day after surgery: the difference between group B and group C were statistically significant(P<0.05). In terms of the visual acuity on 1 momth after surgery: three groups have no statistically significant difference(P>0.05).

CONCLUSION:Manual fragmentation has obvious advantages in removing nuclear above Ⅳ grade; The water irrigation method has fewer complications with low incidence of corner edema, which is more preferable in removing the nuclear below Ⅳ grade.