超声乳化白内障吸除联合玻璃体切割及硅油填充术对糖尿病患者角膜的影响  

Effect of phacoemulsification combined with pars plana vitrectomy and silicone oil tamponade on the cornea of diabetic patients

作　　者：江宏冀 徐路星 王新华 汪日强 段永刚 陈娟娟 毛新帮[3] JIANG Hongji;XU Luxing;WANG Xinhua;WANG Riqiang;DUAN Yonggang;CHEN Juanjuan;MAO Xinbang(Graduate School of Medicine,Nanchang University,Nanchang 330006,Jiangxi Province,China;the First Affiliated Hospital of Jiangxi Medical College,Shangrao 334000,Jiangxi Province,China;the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China)

机构地区：[1]南昌大学研究生院医学部,江西省南昌市330006 [2]江西医学高等专科学校第一附属医院,江西省上饶市334000 [3]南昌大学第二附属医院,江西省南昌市330006

出　　处：《微创医学》2024年第4期382-388,共7页Journal of Minimally Invasive Medicine

基　　金：江西省卫健委科技计划项目(编号:202212776);上饶市科技计划项目(编号:2021CZDX43)。

摘　　要：目的 探究糖尿病视网膜病变患者行超声乳化白内障吸除(Phaco)联合玻璃体切割(PPV)及硅油填充术对角膜的影响。方法 选34例(34眼)视网膜病变患者为研究对象,根据是否合并糖尿病将患者分为糖尿病组与非糖尿病组,各17例(17眼)。所有患者均行Phaco联合PPV及硅油填充术治疗,记录两组并发症发生情况,术前及术后1周、1个月、3个月及6个月测量角膜内皮细胞密度(ECD)、中央角膜厚度(CCT)、角膜前表面曲率、角膜后表面曲率及角膜屈光度,比较两组间的角膜数据。结果 术后1周糖尿病组患者的ECD低于非糖尿病组,术后1周、1个月糖尿病组患者的CCT均厚于非糖尿病组,差异均有统计学意义(均P<0.05)。术后1周糖尿病组患者的角膜前表面曲率K1(平坦轴)的SIA值和角膜前表面曲率K2(陡峭轴)的SIA值均高于非糖尿病组,差异均有统计学意义(均P<0.05);术后1周、1个月、3个月、6个月两组患者术后角膜后表面曲率K1(平坦轴)的SIA值、角膜后表面曲率K2(陡峭轴)的SIA值比较,差异均无统计学意义(均P>0.05)。术后1周糖尿病组患者角膜屈光度的SIA值高于非糖尿病组患者,差异有统计学意义(P<0.05);术后1个月、3个月、6个月两组角膜屈光度的SIA值比较,差异均无统计学意义(均P>0.05)。两组患者均未发生超过24 h持续性高眼压,药物治疗后眼压维持正常,无感染性眼内炎发生。结论 Phaco联合PPV及硅油填充术对糖尿病患者角膜内皮细胞、CCT、角膜前表面曲率及角膜屈光度早期损伤较非糖尿病组更明显,但硅油填充后3—6个月内两组患者角膜内皮细胞、CCT、角膜前后表面曲率及角膜屈光度差异均无统计学意义。因此,Phaco联合PPV及硅油填充术对糖尿病视网膜病变患者是一种相对安全的手术方式。Objective To investigate the effect of phacoemulsification(Phaco)combined with pars plana vitrectomy(PPV)and silicone oil tamponade on the cornea of patients with diabetic retinopathy.Methods A total of 34 patients(34 eyes)with retinopathy were selected as research objects,and they were divided into diabetic group and non-diabetic group,with 17 cases(17 eyes)each.All patients were treated with Phaco combine with PPV and silicone tamponade.The occurrence of complications in the two groups was recorded.Corneal endothelial cell density(ECD),central corneal thickness(CCT),corneal anterior surface curvature,corneal posterior surface curvature and corneal diopter were measured preoperative and postoperative 1 week,1 month,3 months and 6 months.And corneal data between the two groups were compared.Results The ECD of the diabetic group was lower than that of the non-diabetic group at 1 week after operation,and the CCT of the diabetic group was thicker than that of the non-diabetic group at 1 week and 1 month after operation,with statistically significant differences(all P<0.05).One week after operation,the SIA values of corneal anterior surface curvature K1(flat axis)and corneal anterior surface curvature K2(steep axis)in the diabetic group were higher than those in the non-diabetic group at 1 week after operation,and the differences were statistically significant(all P<0.05).There were no statistically significant differences in the SIA values of posterior surface curvature K1(flat axis)and corneal posterior surface curvature K2(steep axis)between the two groups at 1 week,1 month,3 months and 6 months after operation(all P>0.05).One week after operation,the SIA value of corneal diopter in diabetic group was higher than that in non-diabetic group,with statistically significant difference(P<0.05).There were no statistically significant differences in the SIA values of corneal diopter between the two groups at 1 month,3 months and 6 months after operation(all P>0.05).In both groups,there was no persistent ocular hypertensi

关 键 词：糖尿病视网膜病变 超声乳化白内障吸除术 角膜内皮细胞 角膜曲率 玻璃体切割 硅油填充术 

分 类 号：R779.6[医药卫生—眼科]