不同分期糖尿病视网膜病变超声乳化术后黄斑的改变  

Macular changes of diabetic retinopathy at different stages after phacoemulsification

作　　者：董方[1] 赵桂秋[1] 王青[1] 王云霄[1] 林静[1] 车成业[1] 

机构地区：[1]青岛大学医学院附属医院眼科,山东省青岛市266003

出　　处：《眼科新进展》2011年第1期46-48,51,共4页Recent Advances in Ophthalmology

基　　金：山东省中医药科技发展计划项目(编号:2009-177)~~

摘　　要：目的通过光学相干断层扫描(optical coherence tomography,OCT)仪测量黄斑区视网膜的厚度,观察不同分期的糖尿病视网膜病变患者超声乳化术后不同时间黄斑区视网膜的改变。方法回顾性分析2009年1月至2010年1月在我院行超声乳化手术的糖尿病患者60例60眼,其中A组为无糖尿病视网膜病变组、B组为非增生期糖尿病视网膜病变组、C组为增生期糖尿病视网膜病变组,每组20例20眼。比较术后1个月3组患者视力、黄斑水肿发生率及术前,术后1d、1周及1个月3组患者黄斑区视网膜的厚度。结果 A组及B组患者术后1个月视力≥0.5者分别占90%、80%,2组比较差异无统计学意义(χ2=0.118,P>0.05)。C组患者视力≥0.5者占70%,与A、B2组相比差异均有统计学意义(χ2=6.00,P<0.05;χ2=4.54,P<0.05)。3组术后1d视网膜厚度与术前比较,差异均无统计学意义(均为P>0.05)。术后1周,3组视网膜厚度分别为(202.80±71.79)μm、(189.10±46.23)μm、(234.10±35.57)μm,术后1个月为(211.30±80.24)μm、(180.90±30.51)μm、(243.30±28.53)μm,均较术前增加,差异均有统计学意义(均为P<0.05),且C组较A、B2组增厚(均为P<0.05)。术后1个月,3组黄斑水肿的发生率分别为10%、10%、45%,C组较A、B2组升高,差异均有统计学意义(均为P<0.05)。结论糖尿病患者超声乳化晶状体吸出术后黄斑区视网膜厚度增加,且糖尿病视网膜病变程度越重,术后黄斑水肿的发生率越高,水肿的程度越重。Objective To investigate the changes of macular retina in patients with diabetic retinopathy at different stages after phacoemulsification by optical coherence tomography（OCT）.Methods About 60 diabetic patients（60 eyes）,who performed phacoemulsification in our hospital from January 2009 to January 2010,were retrospectively analyzed.All cases were divided into group A（non-diabetic retinopathy group）,group B（non-proliferative diabetic retinopathy）and group C（proliferative diabetic retinopathy）,20 cases（20 eyes）in each group.Visual acuity and incidence of macular edema were compared among 3 groups at postoperative 1 month.Retinal thickness at macular area was compared among 3 groups at pre-operation,postoperative 1 day,1 week and 1 month.Results For patients with visual acuity be and more than 0.5 at postoperative 1 month were about 90% in group A and 80% in group B,there was no statistical difference（χ 2=0.118,P0.05）.For patients with visual acuity be and more than 0.5 was about 70% in group C,there were statistical differences for group C compared with group A or group B（χ 2=3.00,P0.05;χ 2=4.54,P0.05）.At postoperative 1 day,there was no difference in retinal thickness for 3 groups compared with that before operation（all P0.05）.Retinal thicknesses were（202.80±71.79）μm,（189.10±46.23）μm,（234.10±35.57）μm in 3 groups at postoperative 1 week,and（211.30±80.24）μm,（180.90±30.51）μm,（243.30±28.53）μm at postoperative 1 month,there were statistical differences compared with that before operation（all P0.05）.The retinal thickness at group C was thicker than that in group A or group B（both P0.05）.The incidences of macular edema were 10%,10%,45% in 3 groups at postoperative 1 month,and group C was higher than that in group A or group B（both P0.05）.Conclusions Retinal thickness at macular area increases in diabetic patients after phacoemulsification.The more severe of diabetic retinopathy,the higher incidence of macular edema.

关 键 词：糖尿病视网膜病变 超声乳化晶状体吸出术 黄斑水肿 光学相干断层扫描 

分 类 号：R774.5[医药卫生—眼科]