方法：选取行超声乳化白内障吸除联合人工晶状体植入术的患者96例96眼，随机分为两组，各48例48眼，使其有可比性。A组患者角膜切口选择右眼在颞上、左眼在鼻上。B组角膜切口根据曲率检查选择在角膜最大子午线轴向。

结果：两组患者术后1wk，1、3mo视力比较差异无统计学意义(P>0.05)。术后1wk，1mo时A组患者角膜散光度分别为4.03±0.41、3.72±0.35D，B组分别为2.96±0.38、1.29±0.15D，均较治疗前明显增高，且A组明显高于B组，差异有统计学意义(P<0.05)。术后3mo时两组患者散光度均与术前差别不大，且两组比较无统计学意义(P>0.05)。术前两组患者散光轴向均以逆规最为常见，术后1wk顺规性散光增多，明显多于术前，术前术后比较差异有统计学意义(P<0.05)，至术后1、3mo顺规性散光逐渐减少，逆规性散光逐渐增加，接近术前。两组患者不同时间角膜散光轴向比较无统计学意义(P>0.05)。

结论：白内障超声乳化术透明角膜切口选择在角膜最大散光子午线方向可以有效减少术后早期散光度数，但是对于远期角膜散光影响不大，而且对患者视力影响不大。在条件允许的情况下，可以通过该方式制作角膜切口，但是考虑到手术复杂性提高，意义不大。

METHODS:Totally 96 patients with cataract who were going to take phacoemulsification and intracular lens(IOL)implantation were selected.They were randomly divided into group A and group B, 48 patients(48 eyes)in each group and both were comparability. Patients in group A were treated with corneal incision on the temporal side if the right eye was the affected one, or on the nasal side if the left eye was affected. Patients in group B were treated with axial corneal incisions on the radial direction determined by the maximum curvature of the cornea.

RESULTS:The difference of visual acuity between two groups at 1wk, 1,3mo after surgeries was not statistically significant(P>0.05). Corneal astigmatism of group A at 1wk and 1mo after surgeries were 4.03±0.41, 3.72±0.35D, respectively, and those of group B were 2.96±0.38, 1.29±0.15D, which were increased compared to those before surgeries. The post-operative corneal astigmatism of group A were significant higher than those of group B(P<0.05). At 3mo after surgeries, the difference of corneal astigmatism between the two groups was not statistically significant(P>0.05). The most common axis of the two groups preoperatively was astigmatism against the rule. At 1wk after surgeries, astigmatism with the rule increased, and the difference of astigmatism with the rule before and after surgeries was significant(P<0.05). The astigmatism with the rule decreased, astigmatism against the rule increased at 1 and 3mo after surgeries, which approximated that before surgeries. The differences of astigmatic axis between the two groups at different time points were not significant(P>0.05).

CONCLUSION:The transparent corneal phacoemulsification incision in the cornea astigmatism maximum radial direction can effectively reduce early postoperative astigmatism, but has little effect on long-term corneal astigmatism and visual acuity. If the conditions permit, doctors can create the corneal incision this way. But considering the increased complexity of the surgery, this is little meaningful.