方法：回顾性分析 2011-10/ 2013-12由同轴微切口白内障超声乳化术初学者完成的1 080眼临床资料。按照手术日期先后顺序分为A，B，C，D 4组，每组270眼。比较各组患者的手术时间、术中累积发散能量(cumulative dissipated energy，CDE)、并发症率、术后1d； 1mo最佳矫正远视力(best corrected distance visual acuity，BCDVA)，分析各组的手术效果。

结果：四组患者在年龄、性别、晶状体核硬度、术后1mo的BCDVA方面差异均无统计学意义(P>0.05)。A组手术时间为25.15±3.11min，显著长于B组(15.20±3.40min)、C组(14.71±3.02min)和D组(14.41±2.91min)，差异有统计学意义(P<0.05)； B、C、D组三组间差异无统计学意义(均P>0.05)。A组Ⅱ级核和Ⅲ级核的CDE高于B组、C组和D组(均P<0.01)。B组(95.9%)、C组(97.8%)和D组(98.5%)的撕囊成功率均高于A组(80.7%)(均P<0.01)。A组后囊膜破裂发生率高于B组、C组和D组(均P<0.05)， 但C组与D组两两比较差异无统计学意义(P>0.05)。A组与B组术后1d角膜水肿发生率和术后1d BCDVA比较差异无统计学意义(P=0.66，P=0.53)。

结论：遵循循序渐进的学习规律，规范训练，选择合适的患者，正确处理并发症等有利于初学者安全的学习同轴微切口白内障超声乳化术。

METHODS:The clinical data of 1 080 eyes of coaxial microincision phacoemulsification performed by beginners from October 2011 to December 2013 was retrospectively analyzed. In order of surgery dates, the patients were equally divided into groups A, B, C and D, 270 eyes in each group. Comparisons were made among the four groups in operation time, cumulative dissipated energy(CDE), rate of intraoperative, and postoperative complications at 1d; and best corrected distance visual acuity(BCDVA)at 1mo postoperatively.

RESULTS: No significant differences were found in age, sex, lens grading, BCDVA at 1mo postoperatively among the four groups(P>0.05). The operation time was significantly longer in group A than in groups B, C and D(25.15±3.11min vs 15.20±3.40min, 14.71±3.02min and 14.41±2.91min, P<0.05). No significant differences were found in the operation time among the other three groups(P>0.05). The CDE of grade Ⅱ and Ⅲ was significantly higher in group A than that in groups B, C and D(95.9%, 97.8% and 98.5%)(P<0.01). The number of continuous curvilinear capsulorhexis(CCC)were performed successfully was significantly less in group A(80.7%)than the other three groups(95.9%, 97.8% and 98.5%)(P<0.01). The incidence of posterior capasular rupture of group A(7.8%)was higher than that of group B(3.7%), group C(1.1%)and group D(0.4%)(P<0.05), but there was no significant difference between group C and group D(P>0.05). There were no significant differences both in the number of corneal edema and BCDVA at 1d between group A and group B.(P=0.66, P=0.53).

CONCLUSION: With learning step by step, appropriate training program, careful case selection, and accurate managing complications, coxial microincision phacoemusification can be safe for a beginner.