高度近视合并糖尿病白内障患者白内障超声乳化术后视网膜黄斑区神经纤维层厚度变化  

Change of macular retinal nerve fiber layer thickness after phacoemulsification for patients with high myopia and diabetes cataract

作　　者：张丽萍 黄靓 刘兴红 文雪 ZHANG Liping;HUANG Liang;LIU Xinghong;WEN Xue(Department of Ophthalmology,The Central Hospital of Shaoyang,Shaoyang 422000,China)

机构地区：[1]邵阳市中心医院眼科,湖南邵阳422000

出　　处：《邵阳学院学报（自然科学版）》2024年第5期15-20,共6页Journal of Shaoyang University：Natural Science Edition

基　　金：邵阳市科技计划项目(2020GZ105)。

摘　　要：目的研究高度近视合并糖尿病白内障患者白内障超声乳化术后黄斑区视网膜神经纤维厚度(macular retinal nerve fiber layer thickness,mRNFLT)变化。方法选择2021年1月至2022年12月邵阳市中心医院收治的接受超声乳化及人工晶体植入术患者48例,其中高度近视合并糖尿病白内障患者24例共28眼,为观察组(IOLMaster 500测量高度近视合并糖尿病白内障患者的眼轴长度,眼轴长度AL>26~≤28 mm),糖尿病白内障患者24例共28眼,为对照组。在白内障超声乳化术前、术后1 d、术后1周、术后1个月对患者mRNFLT值进行检测,评价2组mRNFLT的变化情况。结果不同时间点2组间的mRNFLT值有差别(术前F=0.30,P<0.001,术后1 d F=3.15,P<0.001,术后1周F=0.31,P<0.001,术后1个月F=2.56,P<0.001),2组内不同时间点mRNFLT值有差别(F=20.296,P=0.001),观察组与对照组相比,mRNFLT值较低,相对治疗效果较好。观察组与对照组的mRNFLT值变化趋势有差别(F=243.491,P=0.001)。结论高度近视合并糖尿病白内障患者术后黄斑水肿风险小,糖尿病白内障患者术后黄斑水肿风险显著增加,术后1个月增加最明显。Objective To investigate the changes of macular retinal nerve fiber layer thickness(mRNFLT)in patients with high myopia combined with diabetic cataract after phacoemulsification.Methods A total of 48 patients who underwent phacoemulsification and IOL implantation were selected from January 2021 to December 2022 at The Central Hospital of Shaoyang,28 eyes in 24 cases of high mgipia and diabetic cataract as an observation group(IOLMaster 500 measured their axial length,AL>26 mm~≤28 mm)and 28 eyes were observed in other 24 cases of diabetic cataract as a control group.The mRNFLT was measured before cataract phacoemulsification,1 day after surgery,1 week after surgery,and 1 month after surgery to evaluate the changes in mRNFLT between the 2 groups.Results The mRNFLT of macular area was different between the 2 groups at different time points(preoperative F=0.30,P<0.001,postoperative 1 day F=3.15,P<0.001,postoperative 1 week F=0.31,P<0.001,postoperative 1 month F=2.56,P<0.001).The mRNFLT of macula area changed in each group over time(observation group F=20.296,P=0.001).The mRNFLT in the macula area of the observation group was lower than that of the control group,and the relative therapeutic effect on the observation group was also better.There was a significant difference in the trends of mRNFLT between the control group and the observation group(F=243.491,P=0.001).Conclusion The risk of macular edema is relatively low in patients with high myopia combined with diabetic cataract,while the risk of macular edema significantly increases in patients with diabetic cataract,most obviously one month after surgery.

关 键 词：糖尿病白内障 高度近视 超声乳化人工晶体植入术 视网膜厚度 

分 类 号：R77[医药卫生—眼科]