摘要目的:研究1.8 mm微切口预劈核超声乳化白内障吸除术（PE）治疗核性白内障的效果及其对角膜内皮细胞相关指标的影响。方法:回顾性分析2018年6—12月浙江省宁波市医疗中心李惠利医院120例核性白内障患者的临床资料。其中，采用1.8 mm微切口预劈核PE治疗60例（预劈核组），采用1.8 mm微切口未劈核PE治疗60例（未劈核组）。记录两组有效超声时间、超声能量及术后并发症；比较两组术前1 d及术后1 d、1周、1个月、3个月、6个月、12个月最佳矫正视力、全眼散光程度、角膜内皮细胞相关指标的变化。结果:预劈核组有效超声时间和超声能量明显低于未劈核组[（44.04 ± 8.93） s比（59.03 ± 9.98） s和（11.29 ± 1.08）%比（14.15 ± 1.16）%]，差异有统计学意义（ t = 4.139和5.289， P<0.05）。两组均未发生严重并发症。两组术前1 d和术后1 d最佳矫正视力比较差异无统计学意义（ P>0.05），预劈核组术后1周、1个月、3个月、6个月和12个月最佳矫正视力明显优于未劈核组，差异有统计学意义（ P<0.05）。两组手术前后各时间点全眼散光程度比较差异无统计学意义（ P>0.05）。预劈核组术后各时间点角膜内皮细胞密度和六角形细胞比例明显大于未劈核组，角膜内皮细胞面积和变异系数明显小于未劈核组，差异有统计学意义（ P<0.05）。 结论:1．8 mm微切口预劈核PE治疗核性白内障，可以有效改善术前全眼散光程度，对角膜内皮细胞损伤度更低，患者术后视力恢复更好。

abstractsObjective:To study the therapeutic effect of 1.8 mm micro incision prechop phacoemulsification (PE) in patients with nuclear cataract.Methods:The clinical data of 120 patients with nuclear cataract from June to December 2018 in Ningbo Medical Center Lihuili Hospital were retrospectively analyzed. Among them, 60 patients were treated with 1.8 mm micro incision prechop PE (prechop group), and 60 patients were treated with 1.8 mm micro incision PE (non-prechop group). The effective ultrasonic time and ultrasonic energy were recorded. The changes of optimum corrected vision, astigmatism degree and related indexes of corneal endothelial cells 1 d before operation and 1 d, 1 week, 1 month, 3 months, 6 months, 12 months after operation were compared between 2 groups.Results:The effective ultrasonic time and ultrasonic energy in prechop group were significantly lower than those in non-prechop group: (44.04 ± 8.93) s vs. (59.03 ± 9.98) s and (11.29 ± 1.08)% vs. (14.15 ± 1.16)%, and there were statistical differences ( t = 4.139 and 5.289, <0.05). No serious complications occurred in both groups. There was no statistical difference in optimum corrected vision 1d before operation and 1 d after operation between 2 groups ( P>0.05); the optimum corrected vision 1 week, 1 month, 3 months, 6 months, and 12 months after operation in prechop group was significantly better than that in non-prechop group, and there was statistical difference ( P<0.05). There was no statistical difference in astigmatism degree before and after operation ( P>0.05). The density of corneal endothelial cells and the proportion of hexagonal cells after operation in prechop group were significantly higher than those in non-prechop group, the area of corneal endothelial cells and variation coefficient were significantly lower than those in non-prechop group, and there were statistical differences ( P<0.05). Conclusions:The 1.8 mm micro incision prechop PE to treat nuclear cataract can effectively reduce astigmatism degree after operation and damage corneal endothelial cells in lower degree. And it is better to patients′ postoperative visual recovery.