糖尿病对白内障超声乳化术后后囊膜混浊程度的影响

Effects of diabetes mellitus on degrees of posterior capsule opacification after phacoemulsification

目的观察伴有或不伴有糖尿病视网膜病变(dia-betic retinopathy,DR)的糖尿病患者白内障超声乳化术后后囊膜混浊(posterior capsule opacification,PCO)的程度并分析其原因。方法将80例排除其他眼病的老年性白内障患者分为4组,每组20例。第1组患者无糖尿病,第2、3、4组患者均有糖尿病,第2组不伴有DR,第3组伴有单纯期DR,第4组伴有增生期DR,各组间年龄及性别相匹配。所有患者均接受白内障超声乳化吸出+后房型人工晶状体植入术,手术由同一位医师完成,囊袋内植入同一类型人工晶状体,术中术后处理均一致。随访(32±6)月后,对每位患者PCO程度进行分级(0级～4级)。各组间作多样本的秩和检验并两两比较。结果多样本的秩和检验结果显示各组患者间PCO程度有统计学差异(H=18.264,P=0.0004),进一步作两两比较,除第2组与第3组(t=0.0076,P=0.990)外,第1组与第2组(t=2.047,P=0.044),第1组与第3组(t=2.040,P=0.045),第1组与第4组(t=2.032,P=0.046),第2组与第4组(t=4.080,P=0.0001),第3组与第4组(t=4.072,P=0.0001),组间比较均有统计学差异。结论不伴有DR或伴有单纯期DR的糖尿病患者白内障超声乳化术后PCO程度较无糖尿病者轻,伴有增生期DR的糖尿病患者PCO程度较无糖尿病者重。

Objective To study the degrees of posterior capsule opacification （PCO） in diabetic patients with or without diabetic retinopathy （DR） after phacoemulsification, and analyze its cause. Methods Eighty patients with senile cataract were divided into four groups （20 patients in each group）. Group 1 ： non-diabetic patients; Group 2： diabetic patients without DR; Group 3： diabetic patients with background diabetic retinopathy（BDR） ; Group 4： diabetic patients with proliferative diabetic retinopathy（PDR）. The age and gender of patients in four groups were matched. The patients underwent phacoemulsification and intracapsular intraocular lens （ Acrysof, Alcon） implantation. All surgeries were performed by one surgeon and the treatments were kept consistent. After follow-up for （32 ± 6） months, the degrees of PCO of every patient were graded （grade 0 - grade 4）. Results Kruskal-Wallis test showed there was significant difference among four groups（ H = 18.264, P = 0. 000 4）. Further analysis confirmed statistical difference between Group Ⅰ and Group Ⅱ （ t = 2. 047, P = 0. 044）, Group I and Group Ⅲ （t =2.040, P=0.045）,GroupI and Group Ⅳ（t = 2.032,P = 0.046）,Group Ⅱ and Group Ⅳ（t = 4.080,P = 0.000 1）,Group Ⅲ and Group Ⅳ（t=4.072,P=0.000 1）. Conclusion PCO in diabetic patients without DR or with BDR are less than that in non-diabetic ones, while PCO in diabetic patients with PDR are greater than that in non-diabetic patients.