不同程度非增生期糖尿病视网膜病变白内障超声乳化术后黄斑的改变

Macular changes of different level of NPDR after phacoemusfication

目的应用光学相干断层扫描仪（CirrusHD-OCT）测量黄斑区视网膜的厚度，观察不同程度的非增生期糖尿病视网膜病变（NPDR）白内障行超声乳化吸出术后短时期内黄斑区视网膜的改变。方法回顾性分析2010年6月至2011年6月行晶状体超声乳化吸出的糖尿病患者80例（80眼）。其中A组为无糖尿病视网膜病变组，B组为轻度NPDR组（眼底检查仅有微动脉瘤），C组为中度NPDR组（微动脉瘤，轻于重度NPDR），D组为重度NPDR组（无PDR表现，可出现以下任一表现：①任一象限有多于20处视网膜内出血；②〉2个象限静脉串珠样改变；③〉1个象限显著的视网膜微血管异常）。比较术前A、B、C、D4组术前、术后1周及1个月黄斑区厚度及视力改善、黄斑水肿的发生情况。结论白内障术后黄斑区视网膜厚度增加；糖尿病是促进其发展的危险因素；NPDR白内障术后黄斑区视网膜厚度增加无显著性差异，且术后视力改善亦无明显差别。

Objective With application of optical coherence tomography （Cirrus HD-OCT） for maeular retinal thickness measurement, to discuss macular retinal changes of different levels of nonprolifera- tive diabetic retinopathy （NPDR） patients after phacoemulsification. Methods A retrospective analysis of phacoemulsification in 80 eyes of 80 patients with diabetes from June 2010 to June 2011 in our hospital was done, in which group A was non-diabetic retinopathy group, group B with mild NPDR group （ only micro-an- eurysms in fundus examination） patients, group C with moderate NPDR group （micro-aneurysms, lighter than severe NPDR） patients, group D of severe NPDR group （non-PDR performance, the performance of any of the following may occur： 1. any quadrant more than 20 retinal hemorrhage; 2. 〉 2 quadrants venous change beaded; 3. 〉 1 quadrant of retinal microvascular abnormalities significantly）. Comparison of maeular thickness, visual acuity, the incidence of macular edema in A, B, C, D groups before and 1 week and 1 month alter surgery was done. Conclusion Macular retinal thickness increased after phacoemusification. Diabetes is a risk factor for its development. There was no difference in macular retinal thickness change or in postoperative visual acuity after cataract surgery in patients with NPDR.