方法：单纯白内障患者88例122眼，按切开入路不同随机分为两组：透明角膜组(A组)40例60眼； 巩膜隧道组(B组)48例62眼。观察术前、术后1d； 1wk； 1mo时平均角膜散光度、手术源性散光(surgically induced astigmatism，SIA)、裸眼视力及最佳矫正视力的情况，并进行统计学分析。

结果：术后1d； 1wk； 1mo，两组平均角膜散光度的比较差异均有统计学意义(P<0.05)； 术后1d； 1wk，SIA值差异有统计学意义(P<0.05)，术后1mo，两组SIA值的比较差异无统计学意义(P>0.05)； 术后1d； 1wk，裸眼视力≥0.5及最佳矫正视力≥0.8比较差异均有统计学意义(P<0.05)，术后1mo，两组之间比较差异无统计学意义(P>0.05)。

结论：巩膜隧道切口白内障超声乳化摘除联合人工晶体植入术对角膜散光改变较小，根据角膜地形图指导个性化切口位置，对自身角膜散光的处理更有优势。

METHODS: Totally 88 cases(122 eyes)with pure cataract were randomly divided into two groups. Forty cases(60 eyes)were clarity corneal incision in group A, and 48 cases(62 eyes)were sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism(SIA), uncorrected visual acuity(UCVA)and best correct vision acuity(BCVA)were observed in pre- and post-operation at 1d; 1wk; 1mo.

RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk; 1mo after operation(P<0.05). The SIA had statistically significant difference at 1d(P<0.05); The SIA had no statistically significant difference between two groups at 1mo after operation(P>0.05). UCVA≥0.5 and BCVA≥0.8 had statistically significant difference at 1d; 1wk(P<0.05). There had no statistically significant difference at 1mo after operation(P>0.05).

CONCLUSION: Phacoemulsification with scleral tunnel incision remove combined intraocular lens(IOL)implantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.