347例糖尿病患者白内障超声乳化手术分析

Analysis on ultrasonic phacoemulsification treatment of diabetic cataract in 347 cases

目的探讨糖尿病患者白内障超声乳化吸除联合人工晶体植入术的临床疗效及并发症。方法对347例(486眼)糖尿病患者白内障超声乳化吸除联合人工晶体植入术的临床资料进行回顾性分析。结果术后第1天裸眼视力大于或等于0.5者379眼,占77.98%;0.3～0.5者58眼,占11.93%;0.1～0.3者34眼,占7.00%;<0.1者15眼,占3.09%。术后3个月矫正视力大于或大于0.5者392眼,占80.66%;0.3～0.5者52眼,占10.70%;0.1～0.3者28眼,占5.76%;<0.1者14眼,占2.88%。并发症主要有术中撕囊失败、后囊膜破裂、术后角膜水肿、前房渗出性炎症、黄斑囊样水肿、糖尿病视网膜病变加重及虹膜红变。结论糖尿病合并白内障行超声乳化吸除联合人工晶体植入在控制血糖的情况下实施手术安全、有效,值得推广,但手术技巧的要求比普通白内障高,否则并发症严重。

Objective To investigate the effects and complications of phacoemulsification and IOL implantation of diabetic patients with cataract.Methods To conduct the retrospective analysis on the therapeutic effect and complications of phacoemulsification and IOL implantation of 347 diabetic patients with cataract（486 eyes） in the past four years in our hospital.Results 379 eyes had the postoperative 1d uncorrected visual acuity≥0.5,accounting for 77.98%;58 eyes had 0.3-0.5,accounting for 11.93%;34 eyes 0.1-0.3,accounting for 7.00%;15 eyes 0.1,accounting for 3.09%.The postoperative three-month corrected visual acuity≥0.5 was in 392 eyes（80.66%）;0.3-0.5 was in 52 eyes（10.70%）;0.1-0.3 was in 28 eyes（5.76%）;0.1 was in 14 eyes（2.88%）.The complications were mainly failure of intraoperative capsulorhexis,posterior capsule rupture,postoperative corneal edema,anterior chamber fibrous formation and macular edema.Conclusion If diabetes will be controlled well,cataract phacoemulsification and IOL implantation of diabetic patients with cataract have the ideal visual function recovery after operation and surgical safety,which is worthy of being spread.It needs higher surgical skill,otherwise the complications are serious.