白内障合并糖尿病和爿乍糖尿病白内障超声乳化人工晶体植入术的疗效观察

Effects of ultrasonic emulsification along with implantataion of artificial lens on cataract patients with or without diabetes

目的观察合并糖尿病的白内障与非糖尿病的白内障患者行白内障超声乳化（PHACO）联合人工晶体植入术的治疗效果。方法将85例（91眼）白内障患者分为两组，A组为白内障合并糖尿病组，共14例（16眼）。男6例（8眼），女8例（8眼）；年龄60一83yr。术前视力：光感-0．25。B组为白内障无糖尿病组，共71例（75眼），男24例（24眼），女47例（51眼）；年龄55．93yr。术前视力：光感～0．3。两组均采用PHACO联合人工晶体植入术治疗，A组术前控制血糖。结果①术后d1视力〈0．3，A组9眼（56．3％），B组26眼（34．7％）；0．3〈视力〈0．8，A组4眼（25．0％）。B组41眼（54．7％）；视力〉0．8，A组3眼（18.8％），B组8眼（10．7％）；术后1wk视力〈0．3，A组4眼（25．0％），B组13眼（17．3％）；0．3〈视力〈0．8，A组8眼（50．0％），B组47眼（62．7％）；视力〉0．8，A组4眼（25．0％），B组15眼（20．0％）。②术后d1角膜水肿A组11眼（68．8％），术后4—7d恢复透明，B组29眼（38．7％），术后2～4d恢复透明，术后除A组1眼患者出现前房渗出外，两组患者均无术后感染、前房出血、切口愈合不良、虹膜后粘连、后囊膜破裂、人工晶体脱位、视网膜脱离等并发症发生。结论白内障超声乳化术效果肯定，术后视力恢复良好。合并糖尿病的白内障患者在严格控制血糖的情况下，也可取得良好的手术治疗效果。

Aim To observe the effects of ultrasonic emulsification along with implantataion of artificial lens on cataract patients with or without diabetes. Methods 85 cases with 91 deseased eyes were divided into 2 groups： 14 cases with diabetes who had 16 deseased eyes were in group A, in which there were 6 male patients with 8 deseased eyes and 8 female patients with 8 deseased eyes. The light sensation before operation was ～ 0.25. In group B,there were 71 cases without diabetes, who had totally 75 deseased eyes, in which there were 24 male patients with 24 deseased eyes and 47 female patients with 51 deseased eyes. The light sensation before operation was -0.3. Results On the first day after the operation, the eyesight of 9 eyes （56.3 % ） in group A and 26 eyes （34.7 % ） in group B was less than 0.3.The eyesight of 3 eyes （18.7%） in group A and 8 eyes （10.7%） in group B was more than 0.8. One week after operation, the eyesight of 4 eyes （25.0%） in group A and 13 eyes （17.3%） in group B was less than 0.3.The eyesight of 4 eyes （25.0%） in group A and 15 eyes （20.0%） in group B was more than 0.8. On the first day after the operation, 11 eyes （68.8%） in group A suffered from cornea oedema, and 4 - 7 days later transparence was regained. The transparence of 29 eyes （38.7%） in group B was regained 2- 4 days after operation. All the cases except one had no infections and complications such as hyphema, posterior synechia, cyst membrane rupture, retinal detachment and so on. Conclusion The effects of ultrasonic emulsification is certain and better recovery can be obtained after operation. The method is also effective in the treatment of cases with diabetes.