目的：比较2.2 mm与3.0 mm透明角膜切口超声乳化术治疗年龄相关性白内障(ARC)的临床疗效。

方法：回顾性纳入2025年1月至2025年11月于我院眼科就诊的ARC患者，根据术中切口长度不同分为两组：观察组采用2.2 mm透明角膜切口； 对照组采用3.0 mm透明角膜切口。比较两组患者术中相关指标，手术前后最佳矫正视力(BCVA)； 术后1 wk，1、3 mo术源性散光(SIA)； 术后1、3 d炎症反应(前房闪辉值及前房炎症细胞数)； 术前及术后3 mo角膜内皮细胞参数\〖角膜内皮细胞密度(CECD)、六边形细胞比例(HEX)、细胞面积变异系数(CV)及角膜内皮细胞丢失率\〗； 术后3 mo并发症发生情况。

结果：本研究共纳入ARC患者120例120眼，若患者双眼均符合纳入标准，仅选取右眼入组，观察组60例60眼中男31例，女29例，平均年龄68.93±6.01岁； 对照组60例60眼中男28例，女32例，平均年龄69.25±5.73岁，两组间术前一般资料比较均无差异(均P>0.05)。观察组术中平均超声时间、平均超声乳化能量、累积耗散能量及灌注液使用量均低于对照组(均P<0.01)。术后1 d，1 wk，观察组BCVA优于对照组(均P<0.05)； 术后1、3 mo两组BCVA均无差异(均P>0.01)。术后1 wk，1、3 mo，观察组SIA均小于对照组，且术后3 mo散光轴向变化幅度亦小于对照组(P<0.01)。术后1、3 d，观察组前房闪辉值及前房炎症细胞数均低于对照组(均P<0.01)。术后3 mo，观察组CECD、HEX均高于对照组，CV值及内皮细胞丢失率均低于对照组(均P<0.05)。观察组术后并发症总发生率为11.7%，低于对照组的26.7%(P<0.05)。

结论：与3.0 mm透明角膜切口相比，2.2 mm透明角膜切口超声乳化术治疗ARC，能显著提升超声乳化效率，减轻术后早期炎症反应和SIA，加速视力恢复，并在短期内更有效地保护角膜内皮细胞的功能与形态，降低并发症发生率。

METHODS: ARC patients treated in the Ophthalmology Department of the hospital from January 2025 to November 2025 were retrospectively enrolled and divided into two groups according to the corneal incision size: the observation group underwent 2.2 mm clear corneal incision, while the control group underwent 3.0 mm clear corneal incision. The two groups were compared in terms of intraoperative parameters, pre- and postoperstive best-corrected visual acuity(BCVA), surgically induced astigmatism(SIA)at 1 wk, 1 and 3 mo postoperatively, inflammatory response(anterior chamber flare value and anterior chamber inflammatory cell count)at 1 and 3 d postoperatively, corneal endothelial cell parameters \〖corneal endothelial cell density(CECD), hexagonal cell ratio(HEX), coefficient of variation(CV)of cell area, and corneal endothelial cell loss rate\〗 measured preoperatively and at 3 mo postoperatively, and the incidence of complications within 3 mo after surgery.

RESULTS:A total of 120 ARC patients(120 eyes for patients with bilateral eyes meeting the inclusion criteria, only the right eye was enrolled)were enrolled, with 60 patients(60 eyes)in the observation group(31 males and 29 females, mean 68.93±6.01 y)and 60 patients(60 eyes)in the control group(28 males and 32 females, mean 69.25±5.73 y). No statistically significant differences were observed in preoperative baseline data between the two groups(all P>0.05). The mean intraoperative ultrasound time, mean phacoemulsification energy, cumulative dissipated energy, and volume of irrigation fluid used in the observation group were significantly lower than those in the control group(all P<0.01. At 1 d and 1 wk postoperatively, BCVA in the observation group was significantly better than that in the control group(both P<0.05). At 1 and 3 mo postoperatively, there was no statistically significant difference in BCVA between the two groups(both P>0.01). At 1 wk, 1 and 3 mo postoperatively, SIA in the observation group was significantly lower than that in the control group, and the change in astigmatism axis at 3 mo postoperatively was also significantly smaller in the observation group(P<0.01). At 1 and 3 d postoperatively, the anterior chamber flare value and inflammatory cell count in the observation group were significantly lower than those in the control group(all P<0.05). At 3 mo postoperatively, CECD and HEX in the observation group were significantly higher than those in the control group, while CV and endothelial cell loss rate were significantly lower(all P<0.05). The total incidence of postoperative complications in the observation group was 11.7%, which was significantly lower than that in the control group(26.7%, P<0.05).

CONCLUSION:Compared with the 3.0 mm clear corneal incision, the 2.2 mm clear corneal incision phacoemulsification for ARC can significantly improve phacoemulsification efficiency, reduce early postoperative inflammatory response and SIA, accelerate visual recovery, better preserve the morphology and function of corneal endothelial cells in the short term, and lower the incidence of complications.