中文摘要：

目的观察经透明角膜双切口联合白内障超声乳化＋多焦点人工晶状体植入对伴有老视及散光的白内障患者的临床效果。方法前瞻性临床研究。对2013年5-11月在四川省人民医院眼科选择角膜散光为1．00。1．50D的老年性白内障患者30例45只眼，于角膜最大屈光径线一端做3．2mm透明角膜切口，行白内障超声乳化吸出后，植入多焦点人工晶状体；在角膜最大屈光径线的另一端再做一个3．2mm透明角膜切口，角膜层间注水密闭切口。于术后第1d、1周和1个月随访观察裸眼远视力／近视力及最佳矫正远视力／近视力，并在术后第1周及1个月加做角膜地形图。结果在术后第1周及1个月时，患者的视力得到明显提高，裸眼远视力和最佳矫正远视力差异无统计学意义P〉0．05（t=1．773，P=0．083），裸眼近视力和最佳矫正近视力差异无统计学意义P〉0．05（t=1．000，P=0．323），角膜地形图显示角膜散光较术前减少。结论双切口联合白内障超声乳化手术治疗合并老视及散光的白内障，能有效减少角膜散光；联合多焦点人工晶状体的植入，可消除术后患者对老视镜的依赖，极大提高患者的术后视觉质量，具有较好的临床效果。

英文摘要：

Objective To observe the effect of phacoemulsification with two incisions and implan-tation of multifocal intraocular lens on cataract patients accompanied by presbyopia and astigmatism. Methods Selected 30 patients with cataract （45 eyes） whose corneal astigmatism was between 1.00-1.50D. Each of the 45 eyes received operation of phacoemulsification with two incisions and im-plantation of multifocal intraocular lens. The two incisions located at the two ends of steep shaft of the corneal. The length of each incision was 3.2 mm. At the time points of 1 day, 1 week and 1 month after the surgery, the patients＇ naked visual acuity （distant/near vision） and the best corrected vi-sual acuity （distant/near vision） were checked. At 1 week and 1 month after operation, corneal topogra-phy of the patients was studied. Results At 1 week and 1 month after the operation, the vision of all the patients improved obviously. There was no significant difference between the naked visual acu-ity and best corrected visual acuity （of both distant vision and near vision） （P =0.083, P =0.323）. The corneal astigmatism was reduced. Conclusions Phacoemulsification with two incisions （at two ends of steep shaft of the comeal） can effectively reduce about 1.21D of the corneal astigmatism. And implanta-tion of multifocal intraocular lens can greatly improve both distant vision and near vision.