糖尿病患者超声乳化白内障吸除术后黄斑部微结构形态分析

The macular microstructure analysis in diabetic cataracts after phacoemulsification

目的观察糖尿病患者超声乳化白内障吸除术后黄斑部微结构的形态变化。方法回顾性病例研究。对2012年5月至2013年5月在绍兴市人民医院眼科确诊糖尿病患者并接受超声乳化白内障吸除手术治疗且术中无并发症的患者30例，共37只眼纳入研究；术前、术后1个月对所有术眼行最佳矫正视力（BCVA）和频域光相干断层扫描（OCT）检查，检测术眼黄斑中心凹厚度（central fovealthickness，CFT）及观察黄斑中心凹处各层形态学变化。采用SPSS17．0统计学软件进行分析。结果37只眼中术前BCVA〈0．1为22只眼，0．1～0．5为15只眼；术后1个月BCVA〈0．1为3只眼，0．1～0．5为24只眼，〉0．5为10只眼，视力均有不同程度提高差异有统计学意义（Z=2．283，P〈0．05）。术前及术后1个月CFT分别为（228-45）μm和（232-56）μm，差异无统计学意义（t=1．274，P〉0．05）。术后1个月，5只眼出现黄斑水肿（CME），2只眼出现IS／OS不同程度改变。结论糖尿病患者超声乳化白内障吸除术后短期内CFT略有增加；手术可导致术眼黄斑水肿及术眼IS／OS不同程度改变。

Objective To observe the changes of macular microstructure morphology after phaco emulsification in diabetics. Methods A retrospective case study. Thirty cases （37 eyes） diagnosed with diabetes and underwent phacoemulsification were chosen. The best corrected visual acuity （BC- VA） and the central foveal thickness （CFT） and macular microstructure morphology of each layer were observed preoperatively and 1 month postoperatively. Results The postoperative BCVA 〈0.1 was found in three eyes, BCVA between 0.1 and 0.5 in 24 eyes and 〉0.5 in 10 eyes, ：visual acuity were different degree increased. Preoperative and 1 mouth postoperative CFT was （228-45）gm and （232-56）μm respectively, there was no statistically significant difference. At 1 month postoperatively, macular edema （CME） was found in five eyes, IS/OS the varying degree change in 2 eyes. Conclusions CFT is increased slightly after phacoemulsification in diabetics in the short term. Surgery can cause eye macular edema and the ocular IS/OS the varying degree change.