老年糖尿病患者白内障术后视网膜病变的连续观察

Continuous observation of diabetic retinopathy in senile patients after cataract surgery

目的评价白内障超声乳化摘出联合人工晶状体植入术后老年糖尿病患者的视力效果及视网膜病变的进展状况。方法对179例179眼老年糖尿病白内障患者行超声乳化白内障摘出联合人工晶状体植入术。术后对术眼及对侧非手术眼视网膜病变进行比较。结果术后最佳矫正远视力≥0.5者159眼,其中无糖尿病视网膜病变者78眼,单纯性糖尿病视网膜病变者80眼,增生性糖尿病视网膜病变者1眼;视力结果取决于视网膜病变特别是黄斑病变程度。术眼中79眼、非手术眼中27眼出现视网膜病变进展,表现为视网膜内出血,火焰状出血斑,硬性及棉絮状渗出斑不同程度的增多,视网膜水肿,黄斑病变加剧及进一步的新生血管形成。结论(1)早期手术效果好,与非糖尿病老年白内障术后无明显差别;(2)晚期手术效果差,白内障手术可加速糖尿病视网膜病变进展;(3)早期手术可提高视力,便于眼底观察及激光治疗。

Objective To evaluate the visual effects and retinopathy progress of senile patients with diabetes after phacoemulsiflcation with intraocuwith intraocular lenns implantation was performed in 179 cases of senile diabetic patients. The retinopathy in operative and non-operative eyes was compared postoperatively. Resuits The best corrected visual acutty in 159 eyes was more than 0.5,including 78 eyes of non-diabetic retinopathy, 80 eyes of non-prolfferafive dtnhctic retinopathy and 1 eye of proliferative diabetic retinopathy. The restdts of visual acuity were decided by the degree of retinopathy, especially maculopathy. Progress of retinopathy appeared in 79 operative eyes and 29 non-operative eyes with the performance of retinal hemorrhage, flame bleeding macula, different increase degrees of hard and cottonwool exuelation, retinal edema, aggravatecd maculopathy and further neovascularization . Conclusion （ 1 ） The results of early operation is good, with no significant difference compared with non-diabetic senile cataract; （2）The results of late operation is poor,cataract surgery can accelerate diabetic retinopathy; （3） Early surgery can improve vision, is easy to fundus observationand laser treatment. [ Rec Adv Ophthalmol 2007 ;27 （2） ： 140-141 ]