糖尿病患者小切口白内障囊外摘出术后角膜曲率的变化

The variation of corneal curvature of diabetic patients after small-incision extracapsular cataract extraction

目的分析糖尿病患者非超声乳化小切口白内障囊外摘出术（ECCE）术后角膜曲率的变化。方法2009年4月至2012年4月71例（83眼）分为3组：正常对照组，糖尿病I组（血糖值〈9．0mmol/L），糖尿病Ⅱ组（血糖值≥9．0mmol/L）。术后随访12个月。结果术后3组的角膜水平曲率均较术前增大（P〈0．001）；垂直曲率均较术前减小（P〈0．001）。对照组与糖尿病I组术后3d～12个月，水平曲率差值逐渐在减小（P〈0．05）。糖尿病Ⅱ组术后3d～6个月，水平曲率差值逐渐减小（P〈0．05），术后6～12个月，差值无明显改变（t=0．292，P=0．774）。对照组与糖尿病Ⅱ组术后3d-12个月，垂直曲率差值逐渐减小（P〈0．05）；糖尿病I组术后3d-6个月，垂直曲率差值逐渐在减小（P〈0．05），术后6～12个月，角膜曲率差值无明显改变（t=1．578，P=0．129）。结论正常对照组与糖尿病患者术后各组水平曲率均增大而垂直曲率均减小，其增大和减小的程度均与血糖水平呈正比，随着时间的推移，3个组的角膜曲率均趋向术前的水平改变，即伤口愈合的过程，该过程均在半年到1年的时间内完成。

Objective To analyse the variation of corneal curvature of diabetic patients after small incision non-phacoemulsification extraeapsular cataract extraction. Methods The data of 83 eyes of 71 patients with cataract and diabetic from Apr. 2009 to Apr. 2012 were collected and all cases were divided into 3 groups： normal control group, diabetic group I （blood glucose 〈 9.0 mmol/L） and diabetic group Ⅱ （blood glucoses〉9.0 mmol/L）. The follow-up time was 12 months. Results Horizontal corneal curvature （HCC） of the three groups after surgery were higher than that of before surgery, the difference was statistically significant （P 〈 0. 001 ）. Vertical corneal curvature （ VCC ） after surgery were lower than that before surgery （ P 〈 0. 001 ）. The difference value of HCC in control group and diabetic group I were decreased 3 days-12 months after surgery （P 〈 0.05 ）. The difference value of HCC in diabetic group Ⅱ was decreased from 3 days to 6 months after surgery （ P 〈 0.05 ） , the difference value was not changed from 6 to 12 months after surgery （t = 0. 292 ,P = 0. 774）. The difference value of VCC in control group and diabetic group Ⅱ were decreased 3 days-12 months after surgery （ P 〈 0.05 ）. The difference value of VCC in diabetic group I was decreased 3 days-6 months after surgery （ P 〈 0.05 ） , the difference value remained stable at 6-12 months after surgery （ t = 1. 578,P = 0. 129 ）. Conclusion HCC of the three groups are elevated and VCC are decreased, the degree of change is proportional to the level of blood glucose, the healing process of corneal acomplishes almost from half year to 1 year.