相干光断层扫描在糖尿病合并白内障术前临床应用

Clinical research of optical coherence tomography before phacoemulsification in complicated cataract of diabetes

目的探讨相干光断层扫描(OCT)在糖尿病合并白内障患者施行超声乳化术前的临床应用价值。方法选取2011年4月至2013年4月确诊为糖尿病,在我院行白内障超声乳化吸除联合人工晶状体植入术的患者216例(259只眼),术前均行裂隙灯下前置镜及OCT扫描检查眼底,并比较检查结果。结果术前裂隙灯下前置镜检查发现黄斑部病变55只眼,包括黄斑水肿15只眼,黄斑前膜8只眼,黄斑渗出16只眼,黄斑出血15只眼,黄斑裂孔1只眼;术前OCT检查发现黄斑部病变144只眼,包括黄斑水肿55只眼,黄斑前膜41只眼,黄斑渗出21只眼,黄斑出血23只眼,黄斑裂孔4只眼。两者比较,OCT眼底病变的检出率显著高于裂隙灯下前置镜检查(P<0.05)。结论糖尿病合并白内障患者术前行OCT检查有助于提高眼底病变的检出率,对手术预后的评估有重要的指导意义,有较高的临床应用价值。

Objective To investigate the clinical value of OCT （ optical coherence tomography ） in phacoemulsifi-cation for complicated cataract in diabetes .Methods 259 eyes of 216 diabetic patients received phacoemulsification and intraocular lens implantation after evaluated with pre-slit lamp microscopy and OCT fundus scanning .Results Macular diseases, including macular edema （15 eyes）, epiretinal membrane （8 eyes）, macular exudates （16 eyes）, hemorrhages （15 eyes）, and macular hole （1 eye）, found by supplementary lens in 55 eyes before phacoemulsification .However, these conditions were detected in more pateints （ 144 eyes ） using OCT .Specifically , we observed macular edema in 55 eyes, epiretinal membrane in 41 eyes, macular exudates in 21 eyes, hemorrhages in 23 eyes, and macular hole in 4 eyes u-sing OCT scanning.OCT fundus lesion detection rate was significantly higher than pre-slit lamp microscope （ P 〈0.05）. Conclusions OCT has a higher sensitivity to detect fundus disease before phacoemulsification in complicated cataract of diabetes .