方法：选择年龄相关性白内障患者67例88眼，接受白内障超声乳化摘除(phacoemulsification，Phaco)联合人工晶状体植入术者35例46眼纳入Phaco组，接受非超声乳化小切口白内障囊外摘除(extracapsular cataract extraction，ECCE)联合人工晶状体植入术者32例42眼纳入ECCE组，用角膜地形综合分析仪定量分别测量各组术前和术后1d，1、3mo的首次非侵犯性泪膜破裂时间(the first non-invasive tear break-up time，fNIBUT)、平均非侵犯性泪膜破裂时间(the average non-invasive tear break-up time，aNIBUT)、泪河高度(tear meniscus height，TMH)，统计TMH异常的比例、泪膜稳定性分级中诊为“干眼”的比例，并进行统计学分析。

结果：术后1d，Phaco组的fNIBUT、aNIBUT、TMH均高于ECCE组，Phaco组干眼比例低于ECCE组； 术后1mo Phaco组的aNIBUT仍高于ECCE组，术后3mo两组各指标差异均无统计学意义(P>0.05)； Phaco组，与术前比较，aNIBUT术后1d下降，TMH术后1d和1mo下降，TMH异常比例术后1mo升高； ECCE组，与术前比较，aNIBUT和TMH在术后1d和1mo均下降，TMH异常比例在术后1d和3mo升高，干眼比例在术后1d和1mo升高。

结论：用角膜地形综合分析仪评估发现，ECCE对泪膜的影响时间较Phaco长，术后的干眼状态持续更久。

METHODS:Eighty-eight eyes in 67 patients with age related cataract were included in the study. Forty-six eyes in 35 patients underwent phacoemulsification(Phaco)combined with intraocular lens implantation as Phaco group,while 42 eyes in 32 patients underwent non-phacoemulsification small incision extra-capsular cataract extraction(ECCE)combined with intraocular lens implantation as ECCE group. The first non-invasive tear break-up time(fNIBUT),the average non-invasive tear break-up time(aNIBUT),the tear meniscus height(TMH)and the proportion of "dry eye" diagnosised in tear film stability grades before operations and at 1d,1 and 3mo after operations were recorded and analyzed.

RESULTS:The fNIBUT, aNIBUT, TMH in Phaco group were higher than those in ECCE group,while the proportion of dry eye in Phaco group were lower than that in ECCE group at 1d postoperatively. The aNIBUT in Phaco group was still higher than that in ECCE group at 1mo postoperatively. The differences on these indicators between two groups were not statistically significant at 3mo postoperatively. Compared with that preoperatively, aNIBUT was reduced at 1d postoperatively, TMH was reduced at 1d and 1mo postoperatively, while the ratio of patients with abnormal TMH was increased 1mo postoperatively in Phaco group. The aNIBUT and TMH were reduced at 1d and 1mo postoperatively, the ratio of patients with abnormal TMH was increased at 1d and 3mo postoperatively, while the proportion of dry eye was increased at 1d and 1mo postoperatively in ECCE group.

CONCLUSION:ECCE has more negative effects on the tear film stability than Phaco, which causes longer dry eye according to the Oculus Keratograph.