目的：观察同轴1.8mm微切口白内障超声乳化吸除术治疗伴有糖尿病的白内障患者的疗效。

方法：选取2017-01/2018-12在我院眼科治疗的白内障患者130例130眼，患者均伴有2型糖尿病。将所有患者按数字表法随机分为观察组和对照组，其中观察组63眼行同轴1.8mm微切口白内障超声乳化吸除联合IOL植入术，对照组67眼行3.0mm传统切口白内障超声乳化吸除联合IOL植入术。记录术中平均超声能量(AVE)和有效超声时间(EPT)，手术前后分别检查术眼最佳矫正视力(BCVA)、角膜内皮细胞密度和角膜散光，同时记录两组术后不良反应和手术并发症情况。

结果：观察组和对照组术后7d，1、3mo时BCVA均较术前提高(P<0.05)。两组患者间AVE有差异(t=3.89，P<0.05)，而两组间EPT无差异(t=0.773，P=0.221)。术前两组患者角膜内皮细胞密度无差异(t=1.21，P=0.114)； 通过重复测量的多因素方差分析，两组间不同时间点角膜内皮细胞密度差异有统计学意义(F_组别=84.216，F_时间=132.435，F_交互=42.173； 均P<0.05)。两组患者间不同时间点术源性散光比较，差异有统计学意义(F_组别=12.256，F_时间=21.436，F_交互=10.224； 均P<0.05)。所有患者术后发生严重角膜水肿10眼，其中观察组4眼，对照组6眼，无其他严重手术并发症。

结论：在糖尿病患者中，同轴1.8mm微切口超声乳化白内障吸除术较传统3.0mm切口对角膜内皮的损伤更小，且不易造成手术源性散光，因此对伴有糖尿病的白内障患者更安全有效。

METHODS: Totally 130 eyes in 130 patients with type 2 diabetes mellitus were underwent phacoemulsification from January 2017 to December 2018, and they were randomly divided into observation group of 63 cases(63 eyes)and control group of 67 cases(67 eyes). The best corrected visual acuity(BCVA)of the two groups were compared. Average phacoemulsification energy(AVE), effective phacoemulsification time(EPT)were recorded of two groups. Corneal endothelial cell counts, corneal astigmatism and complications of two groups were compared preoperatively and 1wk, 1mo and 3mo postoperatively.

RESULTS: The BCVA in observation and control groups were improved after 7d, 1, 3mo operation(P<0.05). The differences of AVE(t=3.89, P<0.05)in observation and control groups were significant, while EPT(t=0.773, P=0.221)between them were not. The corneal endothelial cell counts between the two groups was not significantly different before surgery(t=1.21, P=0.114), while it reduced a lot postoperatively in both groups. The surgically induced corneal astigmatism of the observation group was much smaller than that of the control group, and the differences were statistically significant. The main complication was corneal edema.

CONCLUSION: The 1.8mm coaxial micro-incision phacoemulsification is helpful to reduce surgically induced astigmatism and has less effect on corneal endothelial cell of patients with type 2 diabetic comparing to normal 3.0mm incision phacoemulsification.