目的对比硬核白内障小切口非超声乳化手术中采用前房内碎核和扩大切口娩核两种方法的效果。方法Ⅳ～Ⅴ级硬核白内障216例(247眼)行白内障小切口非超声乳化手术。其中165眼采用扩大切口娩核,82眼采用前房内碎核,术后1d、1周、1个月检查视力,观察术后并发症,对两组进行对比分析。结果扩大切口娩核的有2眼(1.21%)发生后囊破裂,前房内碎核的有5眼(6.10%)发生;术后1d视力扩大切口娩核组优于前房内碎核组,而术后1周和1个月视力两组没有显著差别;术后1d前房内碎核组角膜内皮水肿的发生率和程度高于扩大切口娩核组,术后1周和1个月没有明显差别;术后1个月前房内碎核组的散光低于扩大切口组。结论硬核白内障手法小切口非超声乳化手术中采用扩大切口娩核可以减少手术近期并发症,前房内碎核需要熟练后才能显现小切口的优越性。 Objective To compare the effects of two methods of using anterior chamber cruscle and expanding incision in non-phacoemulsification of hard nucleus cataract. METHODS: Totally 216 cataract patients (247 eyes) with stage IV-V cataract were treated with small incision non-phacoemulsification. One hundred and fifty-five eyes were treated by enlarging incision and delivery, 82 eyes were treated with anterior chamber crush, visual acuity was observed at 1 day, 1 week and 1 month after operation. Postoperative complications were observed and the two groups were compared. Results There were 2 eyes (1.21%) in the enlarged incision posterior capsule rupture, and 5 (6.10%) in the anterior chamber intraocular nuclear. Extensions with visual acuity were superior to those in the anterior chamber crush group , While 1 week and 1 month postoperative visual acuity was no significant difference between the two groups; 1d postoperative intraocular crush group corneal endothelial edema incidence and extent of expansion incision nuclear delivery group, 1 week and 1 month after surgery There was no significant difference; astigmatism in the crushed nuclear group was lower than that in the enlarged incision group 1 month after surgery. Conclusions Hard nuclear cataract surgery in small incision non-phacoemulsification surgery using extended incision delivery can reduce the recent surgical complications, anterior chamber crushing need to be skilled in order to show the superiority of small incisions.