比较糖尿病和非糖尿病患者超声乳化术超乳参数和黄斑厚度的变化（英文）

Comparison of phacoemulsification parameters effect on macular thickness changes after uneventful phacoemulsification in diabetic and non-diabetic patients

目的:调查无视网膜病变的糖尿病和非糖尿病患者接受普通白内障手术时,应用具有前房稳定环境(CASE)和加强控制和效率(ICE)的微脉冲超乳技术对患者超乳参数和黄斑中心凹厚度(CFT)变化的影响。方法:前瞻性研究。研究包含120例患者,其中60例患者为2型糖尿病患者,设为糖尿病组(无视网膜病变),另60例设为对照组。所有患者均接受普通白内障超声乳化术。术中记录超乳参数,包括超乳时间和有效超乳时间。术前和术后1、3mo检测记录CFT并计算每次检测中CFT的差异。结果:糖尿病组的平均超乳时间为1.40±0.43min,而对照组为1.44±0.32min,差异无统计学意义(P=0.85)。糖尿病组平均有效超乳时间为20.12±8.82s,对照组为19.24±9.02s,差异无统计学意义(P=0.964)。糖尿病组术前平均CFT为218.4±12.0μm,对照组为222.1±16.6μm,差异无统计学意义(P=0.168)。术后1mo糖尿病组CFT平均增加30.3±37.2μm,对照组平均增加13.1±12.5μm。术后1mo两组CFT明显增加,糖尿病组显著高于对照组(P=0.001)。术后3mo糖尿病组和对照组的平均CFT较术前分别增加12.5±12.4μm与4.6±9.7μm。糖尿病组CFT的增加显著高于对照组(P=0.00)。但分别比较糖尿病组和对照组术后1mo至3mo平均CFT变化,会发现两组均显著减少(P=0.00,P=0.03)。结论:普通超乳手术会使CFT显著增加。糖尿病组和对照组的超乳参数相似。糖尿病组CFT变化大于对照组,但这些症状大部分表现为亚临床,并且仅显示于光学相干断层扫描(OCT)的改变。术后3mo这种变化会恢复或消失,无需治疗。

AIM：To evaluate the effect of phacoemulsification（phaco） parameters in micropulse phaco-tecnology with chamber stabilization environment（CASE） and increased control and efficiency（ICE） mode on central foveal thickness（CFT） changes after uneventful cataract surgery in normal and diabetic patients without retinopathy.METHODS：In this prospective study a total of 120 patients consist of 60 patients with type 2 diabetes mellitus as a diabetic group（DG） without retinopathy and 60 normal subjects as a control group（CG） who underwent uneventful phaco were evaluated.Intraoperative phacoemulsification parameters including phaco time（PT）,and effective phaco time（EPT） were recorded.The CFT measurements were performed preoperatively,at 1and 3mo postoperatively.The CFT differences were calculated in each exam.RESULTS：The mean PT in DG was 1.40±0.43 min and it was 1.44±0.32 min in CG,the difference was not significant（P=0.85）.The mean EPT was 20.12±8.82 s and 19.24±9.02 s in DG and CG respectively which was statistically insignificant（P=0.964）.The mean preoperative CFT was218.4±12.0 pm in DG and 222.1±16.6 pm in CG which was not statistically different（P=0.168）.The mean increment of CFT in DG was 30.3±37.2 pm at 1mo postoperatively,while it was 13.1±12.5 pirn in CG.Even the CFT increments were significant in both groups at 1mo postoperatively,it was statistically higher in DG than that of CG（P= 0.001）.The average CFT increment at 3mo postoperatively comparing to preoperative level was 12.5±12.4 pm and 4.6±9.7 pm in DG and CG respectively.The increment of CFT was significantly higher in DG than that of CG（P=0.00）.But the comparison of the mean CFTs changes from postoperative 1mo and 3mo in both DG and CG,significant decrements were observed in each group（P=0.00 and P=0.03 respectively）.CONCLUSION：The significant increment of CFT following uneventful phaco.With the similar phaco parameters were observed in both normal and diabetic subjects.The CFT changes were higher in DG than that of CG but fortunately these were mostly subclinical and optic coherence tomography（OCT） based changes and regressed or disappeared after 3mo postoperatively therefore not require immediate treatment in both group.