中文摘要：

目的探讨白内障超声乳化联合人工晶体植入术中的3.0mm上方透明角膜切口对角膜屈光的影响。方法回顾性分析2010年6月至2011年1月行白内障超声乳化联合人工晶体植入术78例（82眼）的临床资料。手术切口均位于11点钟方向。依据内切口到角巩缘距离不同分为内切口4组,即：a组〈1.5mm、1.5mm≤b组〈2.2mm、2.2mm≤c组〈3.0mm、d组≥3.0mm。依据切口隧道长度的不同再将所有患眼分为隧道切口4组,即：a组〈1.0mm、1.0mm≤b组〈1.5mm、1.5mm≤c组〈2.0mm、d组≥2.0mm。测量内切口长度、内切口到角巩缘距离、切口隧道长度,计算切口相对损伤面积。术前及术后3个月测量角膜表面的屈光参数及高阶像差。结果内切口a组术后3个月角膜散光从术前的（2.93±1.34）°增加到术后3个月的（3.43±1.34）°（P〈0.01）。隧道切口a组术后3个月角膜散光从术前的（3.13±1.24）°减少到术后的（1.34±1.03）°（P〈0.01）。手术前后角膜高阶像差的多元逐步回归分析显示：内切口到角巩缘距离、切口隧道长度、泪膜破裂时间、相对损伤面积均可与3级和4级高阶像差中的不同参数构成线性回归关系。结论白内障术中的3.0mm透明角膜切口不会对术后角膜的散光造成较大影响,但随着切口到角巩缘距离不同和切口隧道长度不同,均会在不同程度上的增加术后的3级和4级高阶像差。

英文摘要：

Objective To investigate the changes of corneal refraction status after phacoemulsification with 3. 0 mm clear corneal tunnel incision. Methods From June 2010 to January 2011, Seventy-eight consecutive patients （82 eyes） were operated by phacoemulsification combined with intraocular lens implantation. All the cases were operated through self-closed clear corneal incisions located on 11 o＇clock. According to the distance between the inner corneal incisions and corneoscleral limbus, all the eyes were divided into 4 groups ： group a 〈 1.5 mm, 1.5 ≤ group b 〈2. 2 mm,2. 2 mm≤group c 〈3.0 nun,group d≥3.0 mm. According to the length of the tunnel incisions,another 4 groups were subdivided again for all the eyes ： group a 〈 1.0 mm, 1.0 ≤ group b 〈 1.5 mm, 1.5 mm ≤ group c 〈 2. 0 mm ,group d ≥2. 0 ram. The length of the incisions, the distance between the inner incision to corneoscleral limbus, the length of the tunnel incision, the relative damage incision area S1/S2 were measured. The corneal surface refractive parameters and higher-order aberrations were also measured preoperatively and 3 months postoperatively. Results The corneal astigmatism of group ＂a＂ which according to the distance between the inner corneal incisions and corneoscleral hmbus changed from （2.93 ± 1.34） o preoperative to （ 3.43 ± 1.34） ° （ p 〈 0. 01 ） postoperative. The astigmatism in tunnel incision group a changed from（3.13 ± 1.24）° to（1.34 ± 1.03）°3 months after surgery （P 〈 0.01 ）. A multiple regression analysis showed that a lineal relationship existed between the changes of high-order aberrations to the tunnel length of the incision, the inner incision-hmbus distance, BUT, S1/S2,3rd- and 4th high order corneal aberrations. Conclusions The 3.0 mm clear corneal incision in cataract surgery usually does not affect corneal astigmatism. The various intracorneal incisions placed to a certain distance from corneoscleral limbus and the various length of tunnel incisions affect t