2型糖尿病患者超声乳化白内障摘除并人工晶体植入手术后黄斑区光学相干断层扫描改变

Changes of macular thickness under optical coherent tomography in type 2 diabetic patients with cataract after phacoemulsification surgery and IOL implantation

目的观察超声乳化白内障摘除并人工晶体植入手术对2型糖尿病患者黄斑区组织结构的影响。方法分析84例行超声乳化白内障摘除并人工晶体植入术的2型糖尿病患者的病历资料,手术眼与对侧未手术眼进行对照观察,以手术眼为观察组,对侧眼为对照组。分别于术前、术后1 d、7 d及30 d时,记录中心凹视网膜厚度(FRT)及黄斑区容积(PMV)的光学相干断层扫描(OCT)测量资料。结果中心凹视网膜厚度(FRT):观察组和对照组手术前测量结果,差异无统计学意义(P>0.05);手术后1 d,观察组(258.06±23.34)μm,对照组(259.88±21.01)μm,P>0.05;术后7 d,观察组(270.94±20.26)μm,对照组(260.54±20.88)μm,P<0.05;术后30 d,观察组(275.46±25.38)μm,对照组(260.68±22.95μm),P<0.05。黄斑区容积(PMV):手术前两组间差异无统计学意义(P>0.05);手术后1 d,观察组(8.29±0.55)mm3,对照组(8.28±0.54)mm3,P>0.05;术后7 d,观察组(8.68±0.68)mm3,对照组(8.32±0.62)mm3,P<0.05;术后30 d,观察组(9.46±0.73)mm3,对照组(8.34±0.58)mm3,P<0.05。判定术后1个月内黄斑水肿新增/加重者观察组有15只眼,对照组有2只眼。结论 2型糖尿病患者超声乳化白内障摘除并人工晶体植入术后黄斑水肿的发生率增加,水肿程度加重。

Objective To investigate the effects of phacoemulsification surgery and IOL implantation on the macular ar-ea in type 2 diabetic patients with cataract.Methods 84 type 2 diabetic patients with cataract underwent single-eye phacoemulsification operation were enrolled into the study.OCT （Optical coherent tomography）were performed before the operations,and 1 day,7 days,30 days after the operations in all 168 eyes.The 84 operated eyes were assigned to the study group,while the other 84 eyes were assigned to the control group.The FRT（foveal retina thickness）（at 1 mm）and PMV （perimacular volume）（at 6 mm）of the two groups were analyzed with SPSS 19.0.Results FRT：There was no significant difference between the two groups before the surgery（P 〉0.05）,as well as 1day after the surgery （study group 258.06 ±23.34 μm,control group 259.88 ±21.01 μm;P 〉0.05）.However,significant differ-ences were noted at 7 days （study group 270.94 ±20.26 μm,control group 260.54 ±20.88 μm）and 30 days（study group 275.46 ±25.38 μm,control group 260.68 ±22.95 μm;both P 〈0.05）after the surgery.Similar changes also happened in PMV data：before and 1 day after the surgery（P 〈0.05）,at 7 days （study group 8.68 ±0.68 mm3 , control group 8.32 ±0.62 mm3;P 〈0.05 ）,and 30 days （study group 9.46 ±0.73 mm3 ,control group 8.34 ± 0.58 mm3;P 〈0.05）.Macular edema occurred or aggravated in 15 eyes of the study group and 2 eyes of the control group.Conclusion There are more chances of macular edema or aggravation after phacoemulsification surgery and IOL implantation than without for type 2 diabetic patients.