晶状体超声乳化吸出联合人工晶体植入手术治疗糖尿病性白内障患者的可行性  

Feasibility of Phacoemulsification Combined with Intraocular Lens Implantation in the Treatment of Diabetic Cataract Patients

作　　者：张靓 彭冬梅 王华[1] ZHANG Liang;PENG Dongmei;WANG Hua(Department of Ophthalmology,Lianyungang Eye Hospital,Lianyungang,Jiangsu Province,222000 China)

机构地区：[1]连云港市眼科医院眼科,江苏连云港222000

出　　处：《糖尿病新世界》2022年第18期170-174,共5页Diabetes New World Magazine

摘　　要：目的 研究晶状体超声乳化吸出联合人工晶体植入术治疗糖尿病性白内障患者的可行性。方法 回顾性选取2019年2月—2021年12月连云港市眼科医院行晶状体超声乳化吸出联合人工晶体植入术的糖尿病性白内障患者78例(78眼)作为观察组,按1∶1比例采集同期收治行该术式的非糖尿病性白内障患者78例(78眼)作为对照组,均检测术前、术后1周、术后1、3个月两组最佳矫正视力(BCVA)、黄斑中心视网膜厚度(CSMT)、黄斑容积的变化,统计术后并发症发生率;并分析糖尿病性白内障及单纯白内障患者BCVA与CSMT、黄斑容积的关系。结果 观察组术后1、3个月CMST、角膜水肿、黄斑水肿、纤维素样渗出发生率均高于对照组,差异有统计学意义(P<0.05)。观察组术后1个月、术后3个月BCVA与CMST呈负相关(P<0.05);糖尿病性白内障黄斑水肿患者术后1、3个月BCVA低于无黄斑水肿患者,CMST高于无黄斑水肿患者,差异有统计学意义(P<0.05)。糖尿病性白内障黄斑水肿患者术后1、3个月BCVA均与CMST呈负相关(P<0.05)。结论 糖尿病与非糖尿病性白内障患者行超声乳化吸出联合人工晶体植入术均可获得较好的视力改善效果;但前者术后黄斑水肿发生风险更高,且影响术后视力恢复。临床需重视其黄斑区视网膜厚度监测,配合药物干预以减少黄斑水肿发生,促进其视功能恢复。Objective To study the feasibility of phacoemulsification combined with intraocular lens implantation in the treatment of diabetic cataract patients.Methods A total of 78 patients(78 eyes) with diabetic cataract who underwent phacoemulsification combined with intraocular lens implantation in Lianyungang Eye Hospital from February2019 to December 2021 were retrospective selection selected as the observation group.According to the ratio of 1∶1,78 non-diabetic cataract patients(78 eyes) who were treated with this operation during the same period were collected as the control group.The changes of best-corrected visual acuity(BCVA),central macular thickness(CSMT) and macular volume were detected before operation,1 week after operation,1 months,and 3 months after operation in the two groups.The incidence of postoperative complications was counted.The relationship between BCVA,CSMT and macular volume in diabetic cataract and simple cataract patients was also analyzed.Results The CMST at 1 months and 3 months after surgery and the incidence of corneal edema,macular edema and fibrinoid exudation in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The BCVA in the observation group was negatively correlated with CMST at 1 months and 3 months after surgery(P<0.05).The BCVA of patients with diabetic cataract macular edema at 1 months and 3 months after surgery was lower than that of patients without macular edema,and the CMST was higher than that of patients without macular edema,the difference was statistically significant(P<0.05).BCVA at 1 months and 3 months after surgery in patients with diabetic cataract macular edema was negatively correlated with CMST(P<0.05).Conclusion Phacoemulsification combined with intraocular lens implantation can achieve better vision improvement in diabetic and non-diabetic cataract patients.However,the former has a higher risk of postoperative macular edema and affects postoperative visual acuity.Clinical attention should be

关 键 词：白内障 糖尿病 超声乳化吸出联合人工晶体植入术 黄斑水肿 视力 

分 类 号：R587.1[医药卫生—内分泌]