目的 :评价对硬核 (IV+ / V)白内障采用囊外摘除法 (ECCE)的优点 ;探讨术中应用前囊连续环行撕囊 (CCC)后的娩核方法。方法 :角膜缘外 2 mm做一长 7～ 8mm巩膜隧道切口 ,行 CCC直径为 6～ 7mm,以“T”型晶体调位钩及自制撕囊针相互配合将直径 9mm左右的晶体核旋转脱位入前房 ,圈套器套核 ,囊袋内植入人工晶体。结果 :97眼中 94眼撕囊口娩核后仍平滑连续完整 ,囊袋内植入人工晶体 ;3眼发生前囊膜放射状撕裂并延至后囊 ,只有 1眼高度近视未植入晶体 ,另外 2眼仍囊袋内植入晶体。术后第一天 97眼角膜全部清亮 ,瞳孔圆 ,光反应正常。术后一周裸眼视力≥ 0 .5者 85眼占 87.6 %。结论 :对于硬核白内障 ,传统 ECCE仍有意义 ,CCC克服了开罐式截囊的缺陷 ,改进的娩核方法保持了撕囊口的平滑连续性 ,从而确保了囊袋内植入人工晶体 ,使其效果与 PHACO更接近 ,而投资却少 ,适合在基层医院推广。 OBJECTIVE: To evaluate the advantages of extracapsular cataract extraction (ECCE) for hard nucleus (IV + / V) cataract and to explore the method of intrapartum nucleus pulposus (CCC) after intracapsular capsulorhexis (CCC). METHODS: A 7 mm to 8 mm scleral tunnel incision was made 2 mm outside the limbus. The diameter of the CCC was 6-7 mm. The crystal nucleus with a diameter of about 9 mm was dislocated by the coordination of “T” crystal hooks and homemade capsulorhexis. Into the anterior chamber, snare sets of nuclear, capsular bag implanted intraocular lens. Results: In 97 eyes, 94 eyes of the capsulorhexis were smoothly and continuously intact, and the artificial lens was implanted in the capsular bag. The anterior tear of the capsular bag was delayed to the posterior capsule in 3 eyes. Only one eye had no lens implantation in high myopia. 2 eyes still capsular bag implantation of crystals. The first day after surgery 97 corneas all clear, pupil circle, normal light response. One week after uncorrected visual acuity ≥0.5 85 eyes accounted for 87.6%. CONCLUSIONS: Conventional ECCE still makes sense for hard nuclear cataracts. CCC overcomes the shortcomings of can opener-type capsulotomy. The improved delivery method maintains the smooth continuity of the capsulorhexis and thus ensures the intraocular lens implantation in the capsular bag. Make its effect and PHACO closer, but less investment, suitable for promotion in primary hospitals.