目的：探讨不同切口白内障超声乳化手术对年龄相关性白内障患者角膜内皮和泪膜功能的影响。

方法：将我院收治的年龄相关性白内障患者90例90眼随机分为2.2mm组(47例47眼，行2.2mm角膜微切口白内障超声乳化手术)和3.0mm组(43例43眼，行3.0mm透明角膜切口白内障超声乳化手术)，比较两组患者角膜内皮功能、泪膜功能等指标的变化。

结果：两组患者术中平均超声乳化时间(APT)、平均有效超声乳化时间(EPT)、平均超声乳化能量(AVE)及术前和术后1wk眼压分别进行比较，差异均无统计学意义(P>0.05)。两组患者手术前后不同时间泪膜破裂时间(BUT)、基础泪液分泌试验(ST-Ⅱ)、角膜荧光素钠染色(SCSF)评分、角膜内皮细胞(CEC)计数、中央角膜厚度、CEC变异系数比较，差异均有统计学意义(P<0.05)； 两组术后1wk，1mo BUT均明显低于术前(P<0.05)，ST-Ⅱ均显著高于术前(P<0.05)，SCSF评分先升高后下降且均高于术前(P<0.05)，CEC计数均明显低于术前(P<0.05)，中央角膜厚度和CEC变异系数均显著高于术前(P<0.05)； 2.2mm组术后BUT、ST-Ⅱ、SCSF评分、CEC计数、中央角膜厚度及CEC变异系数变化幅度均小于3.0mm组。

结论：2.2mm和3.0mm白内障超声乳化手术对年龄相关性白内障患者角膜内皮功能和泪膜功能可造成一定损害，2.2mm角膜微切口的损害更小，术后早期恢复更快。

METHODS: Totally 90 SC patients(90 eyes)admitted to our hospital were randomly divided into the 2.2mm group(n=47, 47 eyes, 2.2mm corneal micro-incision phacoemulsification)and the 3.0mm group(n=43, 43 eyes, 3.0 mm clear corneal micro-incision phacoemulsification). The indexes of corneal endothelial function and tear film function were compared between the two groups before and after operation.

RESULTS: There was no statistical difference on the average phacoemulsification time(APT), mean effective phacoemulsification time(EPT), average phacoemulsification energy(AVE)and preoperative and postoperative intraocular pressure between the two groups(P>0.05). There were statistical differences on the tear break-up time(BUT), basal tear secretion test(ST-Ⅱ), corneal sodium fluorescein staining(SCSF)score, corneal endothelial cell count, central corneal thickness and the variation coefficient of corneal endothelial cells between the two groups(P<0.05). At 1wk and 1mo after operation, the BUT in the two groups was significantly lower than that before operation(P<0.05)while the ST-Ⅱ was significantly higher than that before operation(P<0.05), and the SCSF first increased and then decreased(P<0.05), and corneal endothelial cell count was significantly lower than that before operation(P<0.05), and the central corneal thickness and the variation coefficient of corneal endothelial cells significantly increased(P<0.05). The changed degrees of BUT, ST-Ⅱ, SCSF score, corneal endothelial cell count, central corneal thickness and corneal endothelial cell variation coefficient in the 2.2mm group were less than those in the 3.0mm group(P<0.05).

CONCLUSION: Phacoemulsification for SC patients can cause some damage in corneal endothelial function and tear film function, and 2.2mm corneal micro-incision have less damage and faster early recovery.