目的：探讨在角膜地形图下经透明角膜切口进行超声乳化手术对白内障患者治疗的效果。

方法：前瞻性研究。选择本院2021-02/2023-02收治的白内障患者92例92眼，随机分为两组：对照组46眼采用常规11：00位透明角膜切口，研究组46眼采用最陡峭子午线透明角膜切口。比较两组患者手术前后裸眼视力、角膜表面形态指标\〖包括角膜表面规则指数(SRI)、角膜表面非对称指数(SAI)、角膜表面散光值(CYL)\〗、主观干眼症状问卷量表(SDES)评分、泪膜破裂时间(BUT)及并发症。

结果：所有患者均完成随访。研究组术后1 wk，1、3 mo裸眼视力优于对照组(均P<0.05)； 术后3 mo两组患者SAI、CYL比较均有差异(均P<0.05)； 术后不同时间点研究组SDES评分、BUT波动水平均小于对照组(均P<0.05)； 两组并发症发生率无差异(P>0.05)。

结论：角膜地图引导下行最陡峭子午线透明角膜切口行超声乳化术，可改善白内障患者裸眼视力、尽快恢复角膜表面形态且并发症较少。

METHODS:A total of 92 cataract patients(92 eyes)admitted to our hospital from February 2021 to February 2023 were prospectively selected and randomly divided into two groups: the control group(46 eyes)received the conventional 11:00 clear corneal incision scheme, and the study group(46 eyes)received the steepest meridian clear corneal incision scheme. The uncorrected visual acuity, corneal surface morphology indicators, including surface regularity index(SRI), surface asymmetry index(SAI), and cylinder(CYL), subjective dry eye symptoms questionnaire scoring scale(SDES), tear film break-up time(BUT), and complications were compared between the two groups.

RESULTS:All patients completed the follow-up. The uncorrected visual acuity of the study group was significantly better than that of the control group at 1 wk, 1 and 3 mo after surgery(all P<0.05); there were statistical significance in the SAI and CYL of both groups of patients at 3 mo after surgery(all P<0.05); the fluctuation levels of SDES and BUT in the study group were significantly lower than those in the control group at different time points after surgery(all P<0.05); and there was no statistical difference in complications between the two groups(P>0.05).

CONCLUSION:Under the guidance of corneal topography, phacoemulsification through the transparent corneal incision of the steepest meridian of the cornea can improve the uncorrected visual acuity of cataract patients, restore the corneal surface morphology, and have few complications.