目的：观察角巩膜缘切口超声乳化术治疗白内障的效果。

方法：前瞻性研究。选择2021-10/2022-12本院收治的84例84眼白内障患者，依据随机数字表法分组，对照组42例42眼行上方透明角膜切口超声乳化术，研究组42例42眼行角巩膜缘切口超声乳化术。比较两组的裸眼视力、散光度、眼表功能、角膜知觉、并发症。

结果：两组患者术前术后裸眼视力组间、时间差异有统计学意义(均P<0.05)，两组术前，术后4、12 wk的裸眼视力呈减小趋势(均P<0.05)。两组患者术前术后散光度、角膜荧光素染色试验(FLS)评分组间和时间差异有统计学意义(均P<0.05)，两组患者术前，术后4、12 wk的散光度、FLS评分呈先升再降趋势(均P<0.05)。两组患者术前术后泪膜破裂时间(BUT)比较有差异(均P<0.05)，两组患者术前，术后4、12 wk的BUT呈先降再升趋势(均P<0.05)。两组患者术前术后基础泪液分泌试验(SⅠt)、上方角膜知觉、中央角膜知觉组间、时间比较有差异(均P<0.05)，两组患者术前，术后4、12 wk的SⅠt、上方角膜知觉、中央角膜知觉呈先降再升趋势(均P<0.05)。对照组的并发症总发生率12%(5/42)与研究组14%(6/42)比较无差异(χ²=0.105，P=0.746)。

结论：角巩膜缘切口超声乳化术相较于上方透明角膜切口超声乳化术更能降低对白内障患者裸眼视力、散光度、眼表功能、角膜知觉的不利影响，且并未增加并发症发生。

METHODS: Prospective study. A total of 84 cases(84 eyes)of cataract patients admitted to our hospital from October 2021 to December 2022 were randomly grouped into two groups using the random number table method. The control group consisted of 42 cases(42 eyes)that underwent phacoemulsification with upper transparent corneal incision, while the study group consisted of 42 cases(42 eyes)that underwent phacoemulsification with corneoscleral limbus incision. The uncorrected visual acuity, astigmatism, ocular surface function, corneal sensitivity, and complications were compared between the two groups.

RESULTS: There was a statistically significant difference in uncorrected visual acuity between the two groups of patients before and after surgery, as well as over time(both P<0.05). The uncorrected visual acuity of both groups showed a decreasing trend before and after surgery at 4 and 12 wk(both P<0.05). There were statistically significant differences in preoperative and postoperative astigmatism and corneal fluorescein staining(FLS)scores between the two groups of patients, as well as at different time points(both P<0.05). The astigmatism and FLS scores of the two groups of patients showed a trend of first increasing and then decreasing before and after surgery at 4 and 12 wk(both P<0.05). There was a statistically significant difference in breakup time of tear film(BUT)between the two groups of patients before and after surgery(both P<0.05); the BUT of both groups of patients showed a trend of first decreasing and then increasing before and after surgery at 4 and 12 wk(both P<0.05). There was a statistically significant difference in the Schirmer Ⅰ test(SⅠt), upper corneal sensitivity, and central corneal sensitivity between the two groups of patients before and after surgery, as well as at different times(all P<0.05). The SⅠt, upper corneal sensitivity, and central corneal sensitivity of the two groups of patients showed a trend of first decreasing and then increasing before and after surgery at 4 and 12 wk(all P<0.05). There was no significant difference in the total incidence of complications between the control group(12%, 5/42)and the study group(14%, 6/42; χ²=0.105, P=0.746).

CONCLUSION: Compared to the phacoemulsification with upper transparent corneal incision, the phacoemulsification with corneoscleral limbus incision can reduce the adverse effects on uncorrected visual acuity, astigmatism, ocular surface function, and corneal sensitivity in patients with cataract, and does not increase the incidence of complications.