糖尿病视网膜病变患者白内障术后早期散瞳对瞳孔直径的影响  

Effect of early mydriasis after cataract surgery on pupil diameter in patients with diabetic retinopathy

作　　者：孙林 吴晓强[1] 甯朝兵 Sun Lin;Wu Xiaoqiang;Ning Chaobing(Department of Ophthalmology,Zigong Third People's Hospital,Zigong Sichuan 643020,China)

机构地区：[1]自贡市第三人民医院眼科,四川自贡643020

出　　处：《眼科》2024年第1期53-56,共4页Ophthalmology in China

摘　　要：目的探讨糖尿病视网膜病变患者白内障术后早期散瞳对瞳孔直径的影响。设计随机对照临床试验。研究对象2020年12月至2021年12月于自贡市第三人民医院眼科行白内障手术的糖尿病视网膜病变合并白内障患者256例。方法按随机数表法将患者分为试验组和对照组各128例,试验组术后第1~7天给予复方托吡卡胺滴眼液散瞳,对照组术后第7~14天给予散瞳。充分散瞳后5 min瞳孔直径≥7 mm认为瞳孔直径达标。比较两组临床资料,采用Logistics回归矫正瞳孔直径的影响因素,分析早期散瞳与散瞳后直径的相关关系。主要指标瞳孔直径、瞳孔直径的达标率。结果试验组瞳孔直径的理想达标和总达标(χ^(2)=9.976,P=0.002)均高于对照组。矫正了年龄、糖尿病病程、糖尿病视网膜病变分期、术前矫正视力、糖化血红蛋白水平、尿微量白蛋白肌酐比值水平后,试验组散瞳后的瞳孔直径均大于对照组(P<0.05),术后早期散瞳治疗与散瞳后直径增大独立相关(OR=0.53,95%CI:0.38~0.71,P<0.001)。结论糖尿病视网膜病变患者白内障术后接受早期散瞳者瞳孔直径的达标效果更好,有助于未来的散瞳眼底检查。Objective To investigate the effect of early mydriasis on pupil diameter in patients with diabetic retinopathy after cataract surgery.Design Randomized clinical trial.Participants 256 patients with diabetic retinopathy combined with cataract who underwent cataract surgery in Zigong Third People's Hospital from December 2020 to December 2021.Methods The patients were divided into 128 cases each in the experimental and control group according to the random number table method.The experimental group was given compound tropicamide eye drops to dilate the pupil on the 1st to 7th postoperative days,and the control group was given dilation on the 7th to 14th postoperative days.Pupil diameter≥7 mm at 5 min after the end of pupil dilation was considered to have reached the standard.Comparing the clinical data of the two groups,Logistic regression was used to correct the influencing factors of pupil diameter and analyze the correlation between the early pupil dilation and the diameter after pupil dilation.Main Outcome Measures Pupil diameter and pupil diameter attainment.Results The ideal and total attainment of pupil diameter in the experimental group were higher than that in the control group(χ^(2)=9.976,P=0.002).After adjusted for age,duration of diabetes mellitus,diabetic retinopathy stage,preoperative corrected visual acuity,hemoglobin A1c(HbA1c)level,and albumin creatinine ratio(ACR)level,the pupil diameter after pupil dilation in the experimental group was greater than that in the control group(P<0.05).Early postoperative pupil dilation was independently associated with increased diameter after pupil dilation(OR=0.53,95%CI:0.38~0.71,P<0.001).Conclusion Early postoperative dilation is helpful to the better pupil diameter attainment and larger pupil diameters in the caract patients with diabetic retinopathy.

关 键 词：白内障手术 糖尿病视网膜病变 散瞳 

分 类 号：R779.66[医药卫生—眼科] R587.2[医药卫生—临床医学]