方法：选择2006-06/2013-06行超声乳化摘除联合人工晶状体植入术的412例456眼老年白内障患者，随机分为两组，每组228眼。观察组顺规散光患者选择角膜缘正中上方作切口，逆规散光选在颞侧作切口，斜规散光选在颞上方角膜最大曲率子午线上，无散光者选在颞上方； 对照组全部在角膜缘正中上方作切口。全部患者均采用3mm角巩膜隧道切口，距角膜缘2mm，术后切口不缝合。采用角膜曲率仪测量患者术前及术后不同时间的角膜屈光状态，比较不同手术切口位置对术后角膜散光的影响。

结果：观察组术后1，3mo裸眼视力均明显优于对照组(P<0.05)； 观察组术后1，3mo的平均散光度均明显低于对照组(P<0.05)； 观察组术后3mo角膜散光度与术前相比显著降低(P<0.05)，对照组术后3mo与术前相比显著提高(P<0.05)。

结论：依据患者角膜散光状态，选择角膜曲率最大的子午线上作超声乳化白内障手术切口，可一定程度上矫正术前散光，并相应提高患者视力。

METHODS:Totally 412 patients(456 eyes)who had undergone the phacoemulsification and IOL implantation from June 2006 to June 2013 were randomly divided into two groups(each 228 eyes): observation group(incision above the middle of the limbus for the rule astigmatism, at the temporal for against the rule astigmatism, at the top of the temporal regulation on the maximum curvature of the meridian of the cornea for oblique astigmatism, at the top of the temporal for patients without astigmatism); control group(incision at top and middle of limbus), using a 3mm cornea scleral tunnel incision without suture, 2mm from the limbus. Corneal refractive status of preoperative and postoperative at different times were detected by corneal refractive, comparing the impact of different surgical incision on postoperative corneal astigmatism.

RESULTS:The visual acuity of 1, 3mo postoperative of observation group was significantly better than the control group(P<0.05). The average astigmatism of 1, 3mo postoperative of observation group was significantly lower than the control group(P<0.05). Corneal astigmatism 3mo postoperative of observation group was significantly lower than preoperative(P<0.05). Corneal astigmatism 3mo postoperative of control group was significantly higher than preoperative(P<0.05).

CONCLUSION:Incision at the corneal curvature of the largest radial could correct preoperative astigmatism and improve visual acuity to a certain extent.