方法：对2013-09/2014-08通过“舟山市定海区残疾人康复工程”，在我院行小切口白内障囊外摘除联合人工晶状体植入术治疗的白内障患者425例425眼的临床资料进行回顾性分析。对手术前后视力、平均角膜曲率、角膜散光值，及术中术后并发症等进行统计学对比和重点分析。

结果：白内障患者425例425眼中术前最佳矫正视力：<0.05者99例； 0.05～0.3者326例。晶状体核硬度：Ⅲ级核63例，Ⅳ级核257例，Ⅴ级核105例。术前平均角膜曲率和角膜散光值分别为44.6±1.52D和1.35±0.96D。所有患者均采用小切口白内障囊外摘除联合人工晶状体植入术进行治疗，术后随访3mo。最佳矫正视力：<0.05者5例(脱盲率98.8%)； 0.05～<0.3者8例(脱残率96.9%)； 0.3～<0.5者42例； 0.5～0.8者127例； ≥0.8者243例。术后平均角膜曲率和角膜散光值分别为44.5±1.42 D和1.47±1.00 D，与术前相比均无显著性统计学差异。术中晶状体后囊膜破裂4例(0.9%)，角膜后弹力层脱离3例(0.7%)； 术后短暂性角膜水肿18例(4.2%)，前房积血4例(0.9%)； 无感染性眼内炎、视网膜脱离等严重并发症发生。

结论：小切口白内障囊外摘除联合人工晶状体植入术安全性较高，可有效恢复白内障患者视力。在不具备超声乳化白内障吸除手术条件的地区和医院内开展白内障防盲治盲工作时，是一种安全有效的选择。

METHODS: Clinical data of 425 patients with cataract(425 eyes)were analyzed retrospectively, who received small incision extracapsular cataract extraction combined with intraocular lens implantation in the No.413 Hospital of Chinese PLA, with the help from “handicapped rehabilitation engineering in Dinghai District of Zhoushan City” from September 2013 to August 2014. Visual acuity before and after operation, average corneal curvature, corneal astigmatism and intraoperative and postoperative complications were compared statistically and analyzed emphatically.

RESULTS: In all of the 425 patients with cataract(425 eyes), the preoperative best corrected visual acuity of 99 patients were less than 0.05, and the other 326 patients were 0.05 to 0.3. Classification of lens nucleus hardness: level Ⅲ, 63 cases; level Ⅳ, 257 cases; and level Ⅴ, 105 cases. The preoperative average corneal curvature and corneal astigmatism of all patients were 44.6±1.52D and 1.35±0.96D. All the 425 patients underwent small incision extracapsular cataract extraction combined with intraocular lens implantation. Postoperative follow-up of 3mo results: the best corrected visual acuity: 5 cases were less than 0.05(blindness-free rate 98.8%); 8 cases were 0.05 to <0.3(handicap-overcome rate 96.9%); 42 cases were between 0.3 to <0.5; 127 cases between 0.5 to 0.8 and 243 cases were ≥0.8. Postoperative average corneal curvature and cornea astigmatism were 44.5±1.42D and 1.47±1.00D respectively. There were no statistically significant difference compared with preoperative condition. No severe complications such as infectious endophthalmitis or retinal detachment occurred, except 4 patients(0.9%)with posterior capsular rupture and 3 patients(0.7%)with Descemet's membrane detachment during operation; and 18 patients(4.2%)with transient corneal edema and 4 patients(0.9%)with hyphema after operation.

CONCLUSION: It is effective and safe to apply small incisionextracapsular cataract extraction combined with intraocular lens implantation in blindness prevention and treatment, and it gives excellent visual rehabilitation to cataract patients. Especially in those areas and hospitals having no condition of phacoemulsification, it's a safe and effective alternative when carrying out the program of blindness prevention and treatment.